Healthcare Provider Details

I. General information

NPI: 1174874747
Provider Name (Legal Business Name): SANDRA FIELDS KUHN AUD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2012
Last Update Date: 09/24/2012
Certification Date:
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:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: SANDRA FIELDS KUHN
Title or Position: OWNER
Credential:
Phone: 732-229-4089