Healthcare Provider Details
I. General information
NPI: 1508898107
Provider Name (Legal Business Name): WILMINGTON AUDIOLOGY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2006
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 PENNSYLVANIA AVE SUITE 1-C
WILMINGTON DE
19806-1392
US
IV. Provider business mailing address
2300 PENNSYLVANIA AVE STE 1C
WILMINGTON DE
19806-1333
US
V. Phone/Fax
- Phone: 302-654-1011
- Fax:
- Phone: 302-654-1011
- Fax: 302-654-4313
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 1989026866 |
| License Number State | DE |
VIII. Authorized Official
Name:
JAY
D.
LUFT
Title or Position: OWNER/ENT
Credential:
Phone: 302-654-1011