Healthcare Provider Details

I. General information

NPI: 1144366568
Provider Name (Legal Business Name): BORO AUDIOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 PROSPECT PARK SW
BROOKLYN NY
11218
US

IV. Provider business mailing address

207 PROSPECT PARK SW
BROOKLYN NY
11218-1500
US

V. Phone/Fax

Practice location:
  • Phone: 718-622-3500
  • Fax:
Mailing address:
  • Phone: 718-622-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number00959
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN MA OYIBORHORO
Title or Position: DIRECTOR
Credential: ED.D., F.A.A.A., F.A
Phone: 718-622-3500