Healthcare Provider Details

I. General information

NPI: 1891745758
Provider Name (Legal Business Name): BUFFALO HEARING & SPEECH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 03/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E NORTH ST
BUFFALO NY
14203-1002
US

IV. Provider business mailing address

50 E NORTH ST
BUFFALO NY
14203-1002
US

V. Phone/Fax

Practice location:
  • Phone: 716-885-8318
  • Fax: 716-885-0229
Mailing address:
  • Phone: 716-885-8318
  • Fax: 716-885-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1401201R
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1401201R
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1401201R
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number1401201R
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH COZZO
Title or Position: PRESIDENT/CEO
Credential:
Phone: 716-885-8318