1609849942 NPI number — L. DOERFLER AUDIOLOGY ASSOC. P.C.

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 1609849942 NPI number — L. DOERFLER AUDIOLOGY ASSOC. P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
L. DOERFLER AUDIOLOGY ASSOC. P.C.
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:
1609849942
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
433 FRYE FARM RD
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-6480
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-539-3750
Provider Business Mailing Address Fax Number:
724-539-3751

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
433 FRYE FARM RD
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-6480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-539-3750
Provider Business Practice Location Address Fax Number:
724-539-3751
Provider Enumeration Date:
02/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PLUCKER
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
PRES/AUDIOLOGIST
Authorized Official Telephone Number:
724-539-3750

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  D00549 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0420476 . This is a "UMWA HEARING AID&REP.#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 209368 . This is a "UPMC GROUP PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0001326882 . This is a "BLUE SHIELD GROUP NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 27026 . This is a "HEALTH ASSURANCE/ADVANTRA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 129034 . This is a "UMWA TESTING GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: GPCE8653 . This is a "RAILROAD MEDICARE GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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