Healthcare Provider Details

I. General information

NPI: 1407096019
Provider Name (Legal Business Name): YORKVILLE HEARING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2009
Last Update Date: 10/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4116 249TH ST
LITTLE NECK NY
11363-1655
US

IV. Provider business mailing address

160 W 18TH ST
NEW YORK NY
10011-5403
US

V. Phone/Fax

Practice location:
  • Phone: 516-721-2868
  • Fax:
Mailing address:
  • Phone: 516-721-2868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number15000016862
License Number StateNY

VIII. Authorized Official

Name: DR. MIRIAM DIORIO
Title or Position: DOCTOR OF AUDIOLOGY/ PRESIDENT
Credential: AU.D.
Phone: 516-721-2868