1518114636 NPI number — MRS. NANCY ANN ANDERSON M.S.,CCC-A

Table of content: MRS. NANCY ANN ANDERSON M.S.,CCC-A (NPI 1518114636)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518114636 NPI number — MRS. NANCY ANN ANDERSON M.S.,CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANDERSON
Provider First Name:
NANCY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.,CCC-A
Provider Gender Code:
F

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:
1518114636
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
207 FOOTE AVE
Provider Second Line Business Mailing Address:
DEPT. OF SPEECH AND HEARING
Provider Business Mailing Address City Name:
JAMESTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14701-7077
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-664-8194
Provider Business Mailing Address Fax Number:
716-664-8418

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 FOOTE AVE
Provider Second Line Business Practice Location Address:
DEPT. OF SPEECH AND HEARING
Provider Business Practice Location Address City Name:
JAMESTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14701-7077
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-664-8194
Provider Business Practice Location Address Fax Number:
716-664-8418
Provider Enumeration Date:
08/20/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  000955-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 237600000X , with the licence number: 14000010491 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 14000010491 . This is a "HEARING AID DISPENSER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000955-1 . This is a "AUDIOLOGIST LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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