MEDICARE: DR. NICOLE GROAT AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	41YA00098500	NJ

General Provider Information

NPI Number	:	1154848398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE GROAT AU.D.

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD FL 4
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5187
Country	:	US
Telephone Number	:	914-984-2552
Fax Number	:

Provider Business Practice Location Address
First Line	:	1211 HAMBURG TPKE STE 205
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-5056
Country	:	US
Telephone Number	:	973-633-0808
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2017
Last Update Date	:	03/15/2024

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