Healthcare Provider Details

I. General information

NPI: 1093087967
Provider Name (Legal Business Name): WATSON HEARING AID CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ALBANY AVENUE SUITE G-1
KINGSTON NY
12401-2946
US

IV. Provider business mailing address

1 ALBANY AVENUE SUITE G-1
KINGSTON NY
12401-2946
US

V. Phone/Fax

Practice location:
  • Phone: 845-338-3934
  • Fax: 845-338-3772
Mailing address:
  • Phone: 845-338-3934
  • Fax: 845-338-3772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number14000004764
License Number StateNY

VIII. Authorized Official

Name: MR. ERNEST A. WATSON III
Title or Position: AUDIOPROTHOLOGIST-OWNER
Credential:
Phone: 845-338-3934