1215616446 NPI number — SHORE HEARING AID CENTER INC

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 1215616446 NPI number — SHORE HEARING AID CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHORE HEARING AID CENTER 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:
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:
1215616446
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2122 STATE ROUTE 35
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKHURST
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07755
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-493-0900
Provider Business Mailing Address Fax Number:
732-440-3052

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1018 AMBOY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDISON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-512-1448
Provider Business Practice Location Address Fax Number:
732-440-3052
Provider Enumeration Date:
07/14/2023

Additional Information

Authorized Official

Authorized Official Last Name:
RINDNER
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
732-493-0900

Provider Taxonomy Codes

  • Taxonomy code: 237700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0208558 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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