1245635580 NPI number — ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC

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 1245635580 NPI number — ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC
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:
Provider Other Organization Name Type Code:
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:
1245635580
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
461 PARK AVE S
Provider Second Line Business Mailing Address:
5TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-1902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-815-4327
Provider Business Mailing Address Fax Number:
212-679-6472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
461 PARK AVE 5TH FLOOR
Provider Second Line Business Practice Location Address:
ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10016-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-815-4327
Provider Business Practice Location Address Fax Number:
212-679-6472
Provider Enumeration Date:
10/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BRAL
Authorized Official First Name:
POUYA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
347-815-4327

Provider Taxonomy Codes

  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , 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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