Healthcare Provider Details

I. General information

NPI: 1750355160
Provider Name (Legal Business Name): PAMELA J. METTING AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 10/31/2012
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 TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number000202
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number000202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: