Healthcare Provider Details

I. General information

NPI: 1831601103
Provider Name (Legal Business Name): AUDIOLOGY SERVICES COMPANY USA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2017
Last Update Date: 10/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 EAGLE ROCK AVE STE 202
ROSELAND NJ
07068-1500
US

IV. Provider business mailing address

2501 COTTONTAIL LN
SOMERSET NJ
08873-5125
US

V. Phone/Fax

Practice location:
  • Phone: 973-226-6700
  • Fax:
Mailing address:
  • Phone: 732-529-7120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. EDWAR D BRAUN
Title or Position: VP MANAGED CARE
Credential:
Phone: 732-529-7191