Healthcare Provider Details

I. General information

NPI: 1184943961
Provider Name (Legal Business Name): QUALITY OF LIFE HEARING SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

96-05 QUEENS BLVD SEARS MIRACLE EAR
REGO PARK NY
11374
US

IV. Provider business mailing address

581 STATE ROUTE 17M
MONROE NY
10950-3456
US

V. Phone/Fax

Practice location:
  • Phone: 718-275-5954
  • Fax: 718-275-5964
Mailing address:
  • Phone: 845-238-5514
  • Fax: 845-238-5516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL BOCHTERLE
Title or Position: OWNER
Credential: BC-HIS
Phone: 845-238-5514