Healthcare Provider Details

I. General information

NPI: 1861189276
Provider Name (Legal Business Name): ALEXANDER THOMAS ROOKEY HEARING AID DISPENSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 EVERETT RD
ALBANY NY
12205-1407
US

IV. Provider business mailing address

123 EVERETT RD
ALBANY NY
12205-1407
US

V. Phone/Fax

Practice location:
  • Phone: 518-512-8443
  • Fax: 518-701-2139
Mailing address:
  • Phone: 518-512-8443
  • Fax: 518-701-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number14000071170
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: