Healthcare Provider Details

I. General information

NPI: 1053478487
Provider Name (Legal Business Name): HOUSEOFHEARINGAIDSINC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HIGHWAY 70 LEISURE SQUARE MALL SUITE 14
LAKEWOOD NJ
08701
US

IV. Provider business mailing address

1000 HIGHWAY 70 LEISURE SQUARE MALL SUITE 14
LAKEWOOD NJ
08701
US

V. Phone/Fax

Practice location:
  • Phone: 732-363-5991
  • Fax: 732-364-8590
Mailing address:
  • Phone: 732-363-5991
  • Fax: 732-364-8590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number25MG00037400
License Number StateNJ

VIII. Authorized Official

Name: MRS. GAIL R GROB
Title or Position: PRESIDENT
Credential: HEARINGAIDSPECIALIST
Phone: 732-363-5991