1457323636 NPI number — NASSAU AUDIOLOGICAL PRODUCTS, INC.

Table of content: (NPI 1457323636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457323636 NPI number — NASSAU AUDIOLOGICAL PRODUCTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NASSAU AUDIOLOGICAL PRODUCTS, INC.
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:
NASSAU HEARING SERVICES
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:
1457323636
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 FULTON AVE
Provider Second Line Business Mailing Address:
SUITE 24
Provider Business Mailing Address City Name:
HEMPSTEAD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11550-3646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-538-0899
Provider Business Mailing Address Fax Number:
516-538-0744

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 FULTON AVE
Provider Second Line Business Practice Location Address:
SUITE 24
Provider Business Practice Location Address City Name:
HEMPSTEAD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11550-3646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-538-0899
Provider Business Practice Location Address Fax Number:
516-538-0744
Provider Enumeration Date:
02/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HIRSCH
Authorized Official First Name:
JODI
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR OF AUDIOLOGY
Authorized Official Telephone Number:
516-538-0899

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  000883 , 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: HIP08799 . This is a "HIP-PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000883 . This is a "HIP-VIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000039875 . This is a "AFFINITY HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01121457 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: M25191 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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