Healthcare Provider Details

I. General information

NPI: 1083029276
Provider Name (Legal Business Name): HEARING CENTER OF PLAINVIEW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MANETTO HILL RD STE 102A
PLAINVIEW NY
11803-1311
US

IV. Provider business mailing address

203 SE PARK PLAZA DR STE 290
VANCOUVER WA
98684-3401
US

V. Phone/Fax

Practice location:
  • Phone: 516-931-6630
  • Fax:
Mailing address:
  • Phone: 360-816-2958
  • Fax: 360-816-7156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARK DRAHN
Title or Position: VP OF OPERATIONS
Credential:
Phone: 360-816-2958