Healthcare Provider Details

I. General information

NPI: 1952672339
Provider Name (Legal Business Name): HEARING AID ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25255 GRAVEL HILL RD
MILLSBORO DE
19966-3468
US

IV. Provider business mailing address

25255 GRAVEL HILL RD
MILLSBORO DE
19966-3468
US

V. Phone/Fax

Practice location:
  • Phone: 302-934-1471
  • Fax: 302-934-9687
Mailing address:
  • Phone: 302-934-1471
  • Fax: 302-934-9687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number02-0000122
License Number StateDE

VIII. Authorized Official

Name: MR. MATTHEW TODD FAVINGER
Title or Position: AUDIOLOGIST
Credential: M.S. F-AAA
Phone: 302-934-1471