Healthcare Provider Details

I. General information

NPI: 1801041033
Provider Name (Legal Business Name): HEARING TECHNOLOGIES CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2008
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8715 37TH AVE
JACKSON HEIGHTS NY
11372-7701
US

IV. Provider business mailing address

8715 37TH AVE
JACKSON HEIGHTS NY
11372-7701
US

V. Phone/Fax

Practice location:
  • Phone: 718-507-5200
  • Fax: 718-507-7879
Mailing address:
  • Phone: 718-507-5200
  • Fax: 718-507-7879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number116
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number266
License Number StateNY

VIII. Authorized Official

Name: MRS. SHELLEY BREVDA
Title or Position: MANAGING PARTNER
Credential: CCC/SLP
Phone: 718-507-5200