Healthcare Provider Details

I. General information

NPI: 1821062233
Provider Name (Legal Business Name): FINGER LAKES HEARING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 11/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 ELIZABETH BLACKWELL STREET SUITE C
GENEVA NY
14456
US

IV. Provider business mailing address

64 ELIZABETH BLACKWELL STREET SUITE C
GENEVA NY
14456
US

V. Phone/Fax

Practice location:
  • Phone: 315-789-3595
  • Fax: 315-789-9051
Mailing address:
  • Phone: 315-789-3595
  • Fax: 315-789-9051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD A. HARRY
Title or Position: AUDIOLOGIST/OWNER
Credential:
Phone: 315-789-3595