MEDICARE: SONOTONE ON THE HUDSON, INC.

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	000970	NY
2	231HA2400X	Assistive Technology Practitioner Audiologist	000970	NY
3	237600000X	Audiologist-Hearing Aid Fitter	000970	NY
4	237600000X	Audiologist-Hearing Aid Fitter	14000012300	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	W21354	OTHER	NY	OXFORD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4806617	OTHER	NY	GHI
4	5606045	OTHER	NY	AETNA US HEALTHCARE

General Provider Information

NPI Number	:	1578545588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SONOTONE ON THE HUDSON, INC.

Provider Business Mailing Address
First Line	:	43 PINESBRIDGE ROAD
Second Line	:
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-4333
Country	:	US
Telephone Number	:	914-819-3898
Fax Number	:	914-944-1557

Provider Business Practice Location Address
First Line	:	2017 WILLIAMSBRIDGE ROAD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1606
Country	:	US
Telephone Number	:	718-678-8277
Fax Number	:	718-678-8278

Authorized Official
Title or Position	:	AUDIOLOGIST
Name	:	STEPHANIE ELAINE ROBINSON FROMMELT
Credential	:	M.A., CCCA
Telephone Number	:	914-819-3898

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	04/25/2018

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