1215197140 NPI number — HEARITE AUDIOLOGICAL SERVICES PLLC

Table of content: (NPI 1215197140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215197140 NPI number — HEARITE AUDIOLOGICAL SERVICES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEARITE AUDIOLOGICAL 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:
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:
1215197140
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1410 48TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11219-3243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-853-4327
Provider Business Mailing Address Fax Number:
718-853-1754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1410 48TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11219-3243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-853-4327
Provider Business Practice Location Address Fax Number:
718-853-1754
Provider Enumeration Date:
06/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KAUFMAN
Authorized Official First Name:
MIRIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
AUDIOLOGIST
Authorized Official Telephone Number:
718-853-4327

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  1381-1 , 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: 138430101 . This is a "HEALTH PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2205539 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01985542 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5C3975 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1868136 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2542110 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4899936 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: BK0227901 . This is a "AMERICHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: M90101 . This is a "EMPIRE" identifier . This identifiers is of the category "OTHER".




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