Healthcare Provider Details

I. General information

NPI: 1396800561
Provider Name (Legal Business Name): ATLANTIC HEARING AID CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 ATLANTIC AVENUE IRVIN WIENER
MARGATE NJ
08402
US

IV. Provider business mailing address

9400 ATLANTIC AVENUE IRVIN WIENER
MARGATE NJ
08402
US

V. Phone/Fax

Practice location:
  • Phone: 609-822-8662
  • Fax: 609-822-2602
Mailing address:
  • Phone: 609-822-8662
  • Fax: 609-822-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number25MG00020500
License Number StateNJ

VIII. Authorized Official

Name: MR. IRVIN WIENER
Title or Position: OWNER
Credential:
Phone: 609-822-8662