Healthcare Provider Details

I. General information

NPI: 1588835425
Provider Name (Legal Business Name): STELLA PASCHOVER AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STELLA GERSHKOVICH

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 LAKEVILLE RD
NEW HYDE PARK NY
11042-1121
US

IV. Provider business mailing address

1976 OCEAN AVE 2ND FLOOR
BROOKLYN NY
11230-6719
US

V. Phone/Fax

Practice location:
  • Phone: 718-470-8910
  • Fax:
Mailing address:
  • Phone: 718-470-8910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2175
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number2175
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2175
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: