1255591988 NPI number — FAMILY AUDIOLOGY SERVICES PLLC

Table of content: (NPI 1255591988)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255591988 NPI number — FAMILY AUDIOLOGY SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FAMILY AUDIOLOGY SERVICES 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:
FAMILY HEARING CENTER
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:
1255591988
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18 WESTAGE BUSINESS CTR DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FISHKILL
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12524-2219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-897-3059
Provider Business Mailing Address Fax Number:
845-897-3254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 WESTAGE BUSINESS CTR DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FISHKILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12524-2219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-897-3059
Provider Business Practice Location Address Fax Number:
845-897-3254
Provider Enumeration Date:
06/16/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BIASOTTI
Authorized Official First Name:
LORI
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
DOCTOR OF AUDIOLOGY
Authorized Official Telephone Number:
845-897-3059

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  001245-1 , 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)

  • Identifier: 06321 . This is a "HEAR USA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 640004235 . This is a "RAILROAD RETIRED MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P600485 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 958209 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 46465 . This is a "GHI-HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1C1391 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P11157130 . This is a "MULTI-PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1745703 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 50355269 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6015687 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: M2467 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10034802 . This is a "CDPHP" identifier . This identifiers is of the category "OTHER".




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