MEDICARE: MRS. JOANNE TZORTZATOS MS,CCC-A, AUD

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	0018561	NY
2	237600000X	Audiologist-Hearing Aid Fitter	14000014873	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275744286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOANNE TZORTZATOS MS,CCC-A, AUD

Provider Business Mailing Address
First Line	:	74-20 25TH AVENUE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11370-1428
Country	:	US
Telephone Number	:	718-350-3171
Fax Number	:	718-458-1367

Provider Business Practice Location Address
First Line	:	74-20 25TH AVENUE
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11370-1428
Country	:	US
Telephone Number	:	718-350-3171
Fax Number	:	718-458-1367

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	02/19/2016

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