Healthcare Provider Details

I. General information

NPI: 1659785533
Provider Name (Legal Business Name): ENGLE AUDIOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 06/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10052 KEYSER POINT RD
OCEAN CITY MD
21842-9748
US

IV. Provider business mailing address

10052 KEYSER POINT RD
OCEAN CITY MD
21842-9748
US

V. Phone/Fax

Practice location:
  • Phone: 443-664-2080
  • Fax: 443-664-2080
Mailing address:
  • Phone: 443-664-2080
  • Fax: 443-664-2080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number00786
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number00786
License Number StateMD

VIII. Authorized Official

Name: DR. KATHERINE BOZMAN ENGLE
Title or Position: OWNER/AUDIOLOGIST
Credential:
Phone: 443-664-2080