Healthcare Provider Details

I. General information

NPI: 1609854686
Provider Name (Legal Business Name): ANTONY R JOSEPH AUD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 482 BOX 1600 DCH AUDIOLOGY CLINIC
FPO AP
96362-0199
US

IV. Provider business mailing address

PSC 482 BOX 109
FPO AP
96362-0199
US

V. Phone/Fax

Practice location:
  • Phone: 011816117437806
  • Fax: 011816117437811
Mailing address:
  • Phone: 011816117437806
  • Fax: 011816117437811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD00117
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: