Healthcare Provider Details

I. General information

NPI: 1427757905
Provider Name (Legal Business Name): SYDNEY KAISER AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2023
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 COLLEGE RD STE B
GREENSBORO NC
27410-5164
US

IV. Provider business mailing address

529 COLLEGE RD STE B
GREENSBORO NC
27410-5164
US

V. Phone/Fax

Practice location:
  • Phone: 336-295-1064
  • Fax:
Mailing address:
  • Phone: 336-295-1064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: