Healthcare Provider Details

I. General information

NPI: 1255394284
Provider Name (Legal Business Name): JAMES RICHARD HARTER MA-CCC-A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 10/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 CHURCH ST
LANCASTER NY
14086-2638
US

IV. Provider business mailing address

56 CHURCH ST
LANCASTER NY
14086-2638
US

V. Phone/Fax

Practice location:
  • Phone: 716-681-6722
  • Fax:
Mailing address:
  • Phone: 716-681-6722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number001290-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: