Healthcare Provider Details

I. General information

NPI: 1710975149
Provider Name (Legal Business Name): AURORA AUDIOLOGY & SPEECH ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 07/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

97 HAMBURG ST
EAST AURORA NY
14052-2139
US

IV. Provider business mailing address

97 HAMBURG ST
EAST AURORA NY
14052-2139
US

V. Phone/Fax

Practice location:
  • Phone: 716-652-6464
  • Fax: 716-652-6499
Mailing address:
  • Phone: 716-652-6464
  • Fax: 716-652-6499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE STEWART
Title or Position: OWNER
Credential: AU.D.
Phone: 716-652-6464