Healthcare Provider Details

I. General information

NPI: 1861677031
Provider Name (Legal Business Name): ADVANCED AUDIOLOGY & HEARING AID SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2008
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NEWTOWN RD SUITE 2A
DANBURY CT
06810-4146
US

IV. Provider business mailing address

107 NEWTOWN RD SUITE 2A
DANBURY CT
06810-4146
US

V. Phone/Fax

Practice location:
  • Phone: 203-830-4705
  • Fax: 203-730-4174
Mailing address:
  • Phone: 203-830-4705
  • Fax: 203-730-4174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: RICHARD LIPTON
Title or Position: M.D.
Credential:
Phone: 203-830-4700