Healthcare Provider Details

I. General information

NPI: 1972911287
Provider Name (Legal Business Name): NORTH JERSEY HEARING AID CENTER, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2014
Last Update Date: 07/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 FAIRFIELD AVE STE 4B
WEST CALDWELL NJ
07006-6419
US

IV. Provider business mailing address

195 FAIRFIELD AVE STE 4B
WEST CALDWELL NJ
07006-6419
US

V. Phone/Fax

Practice location:
  • Phone: 201-787-4368
  • Fax: 888-971-3738
Mailing address:
  • Phone: 201-787-4368
  • Fax: 888-971-3738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number25MG00123000
License Number StateNJ

VIII. Authorized Official

Name: MR. JUSTIN HAWORTH
Title or Position: OWNER
Credential:
Phone: 201-787-4368