1093087744 NPI number — KRISTA SZALC, AUDIOLOGY, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093087744 NPI number — KRISTA SZALC, AUDIOLOGY, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KRISTA SZALC, AUDIOLOGY, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HORNELL, DANSVILLE, WARSAW HEARING CENTERS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093087744
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 685
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HORNELL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14843-0685
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-324-0467
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 RED JACKET ST
Provider Second Line Business Practice Location Address:
SUITE 16
Provider Business Practice Location Address City Name:
DANSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14437-1758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-324-0467
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
SZALC
Authorized Official First Name:
KRISTA
Authorized Official Middle Name:
RENEE
Authorized Official Title or Position:
AUDIOLOGIST/OWNER
Authorized Official Telephone Number:
410-375-1013

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  15000020804 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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