Healthcare Provider Details

I. General information

NPI: 1497799001
Provider Name (Legal Business Name): MILLIANO AUDIOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4570 PECAN DR STE A
PADUCAH KY
42001-6717
US

IV. Provider business mailing address

4570 PECAN DR STE A
PADUCAH KY
42001-6717
US

V. Phone/Fax

Practice location:
  • Phone: 270-554-6000
  • Fax:
Mailing address:
  • Phone: 270-554-6000
  • Fax: 270-554-6995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberKY-0245
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberKY-0632
License Number StateKY

VIII. Authorized Official

Name: ANTHONY JOSEPH MILLIANO SR.
Title or Position: OWNER
Credential: AU.D.
Phone: 270-554-6000