Healthcare Provider Details

I. General information

NPI: 1154572568
Provider Name (Legal Business Name): AUDIOLOGY ON DEMAND, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 10/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 MILITARY RD
NIAGARA FALLS NY
14304-1745
US

IV. Provider business mailing address

1629 MILITARY RD
NIAGARA FALLS NY
14304-1745
US

V. Phone/Fax

Practice location:
  • Phone: 716-297-4444
  • Fax: 716-297-4111
Mailing address:
  • Phone: 716-297-4444
  • Fax: 716-297-4111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: PAMELA L FLEMING
Title or Position: OWNER/AUDIOLOGIST
Credential: AU.D.
Phone: 716-297-4444