Healthcare Provider Details

I. General information

NPI: 1316068034
Provider Name (Legal Business Name): BROOKLYN HEARING HEALTH ASSOC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 AVENUE Z
BROOKLYN NY
11235-3809
US

IV. Provider business mailing address

1601 AVENUE Z
BROOKLYN NY
11235-3809
US

V. Phone/Fax

Practice location:
  • Phone: 718-743-8223
  • Fax:
Mailing address:
  • Phone: 718-743-8223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number000910
License Number StateNY

VIII. Authorized Official

Name: MS. DAWN M VONBARGEN-WEINER
Title or Position: AUDIOLOGIST
Credential: MA, FAAA
Phone: 718-743-8223