Healthcare Provider Details
I. General information
NPI: 1245476233
Provider Name (Legal Business Name): BLEICH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/23/2008
Last Update Date: 12/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1909 W STATE ST
OLEAN NY
14760-3361
US
IV. Provider business mailing address
1909 W STATE ST
OLEAN NY
14760-3361
US
V. Phone/Fax
- Phone: 716-372-2671
- Fax: 716-373-4540
- Phone: 716-372-2671
- Fax: 716-373-4540
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332S00000X |
| Taxonomy | Hearing Aid Equipment |
| License Number | 15000016345 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
DEBORAH
LYNN
BLEICH
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 716-832-7203