Healthcare Provider Details
I. General information
NPI: 1902984859
Provider Name (Legal Business Name): PCL HEARING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
777 LARKFIELD RD SUITE 108
COMMACK NY
11725-3136
US
IV. Provider business mailing address
777 LARKFIELD RD STE 108
COMMACK NY
11725-3136
US
V. Phone/Fax
- Phone: 631-543-4327
- Fax: 631-543-3735
- Phone: 631-543-4327
- Fax: 631-543-3735
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | 15000014671 |
| License Number State | NY |
VIII. Authorized Official
Name:
PETER
CHARLES
LORING
Title or Position: OWNER
Credential:
Phone: 516-445-0345