Healthcare Provider Details

I. General information

NPI: 1396348959
Provider Name (Legal Business Name): NORTHEAST OCCUPATIONAL AUDIOLOGY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UNIVERSITY PLZ STE 630
HACKENSACK NJ
07601-6210
US

IV. Provider business mailing address

2 UNIVERSITY PLZ STE 630
HACKENSACK NJ
07601-6210
US

V. Phone/Fax

Practice location:
  • Phone: 201-645-5440
  • Fax: 201-645-5443
Mailing address:
  • Phone: 201-645-5440
  • Fax: 201-645-5443

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. DEANENE V HIGHTOWER
Title or Position: DIRECTOR OF AUDIOLOGY
Credential: AUD
Phone: 201-645-5440