Healthcare Provider Details

I. General information

NPI: 1538107966
Provider Name (Legal Business Name): SANDRA FIELDS KUHN AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SANDRA FIELDS KUHN AU.D

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 03/20/2020
Certification Date: 03/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 MONMOUTH RD
WEST LONG BRANCH NJ
07764-1029
US

IV. Provider business mailing address

223 MONMOUTH RD
WEST LONG BRANCH NJ
07764-1029
US

V. Phone/Fax

Practice location:
  • Phone: 732-229-4089
  • Fax: 732-229-3150
Mailing address:
  • Phone: 732-229-4089
  • Fax: 732-229-3150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number41YA00010400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: