MEDICARE: AK AUDIOLOGY CARE PC

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	002350	NY

General Provider Information

NPI Number	:	1316283658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AK AUDIOLOGY CARE PC

Provider Business Mailing Address
First Line	:	11 GRACE AVE
Second Line	:	SUITE 106
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2446
Country	:	US
Telephone Number	:	516-829-8323
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 GRACE AVE
Second Line	:	SUITE 106
City	:	GREAT NECK
State	:	NY
Zip	:	11021-2446
Country	:	US
Telephone Number	:	516-829-8323
Fax Number	:

Authorized Official
Title or Position	:	AUDIOLOGIST
Name	:	FARRAH KATZ
Credential	:	AUD
Telephone Number	:	516-829-8323

Provider Enumeration Date	:	12/13/2012
Last Update Date	:	12/13/2012

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