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: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UNIVERSITY PLZ STE 226
HACKENSACK NJ
07601-6210
US

IV. Provider business mailing address

2 UNIVERSITY PLZ STE 226
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 Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DEANENE V HARRISON
Title or Position: AUDIOLOGIST
Credential: AU.D.
Phone: 201-645-5440