Healthcare Provider Details

I. General information

NPI: 1639537954
Provider Name (Legal Business Name): INNOVATIVE HEARING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2016
Last Update Date: 02/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 OLD HOOK RD STE 204
WESTWOOD NJ
07675-3248
US

IV. Provider business mailing address

354 OLD HOOK RD STE 204
WESTWOOD NJ
07675-3248
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-8787
  • Fax: 201-358-6686
Mailing address:
  • Phone: 201-666-8787
  • Fax: 201-358-6686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number25MG00048900
License Number StateNJ

VIII. Authorized Official

Name: MS. CATHY GASS
Title or Position: OFFICE MANAGER
Credential:
Phone: 201-666-8787