Healthcare Provider Details

I. General information

NPI: 1932146818
Provider Name (Legal Business Name): EAST RIDGE HEARING & SPEECH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 12/07/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 CROSS KEYS OFFICE PARK SUITE 308
FAIRPORT NY
14450-3511
US

IV. Provider business mailing address

300 CROSS KEYS OFFICE PARK SUITE 308
FAIRPORT NY
14450
US

V. Phone/Fax

Practice location:
  • Phone: 585-388-3818
  • Fax: 585-388-3817
Mailing address:
  • Phone: 585-388-3818
  • Fax: 585-388-3817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: DR. PETER HART
Title or Position: VICE PRESIDENT
Credential: AUD
Phone: 585-266-4130