Healthcare Provider Details

I. General information

NPI: 1508262270
Provider Name (Legal Business Name): AUDIOLOGY BY THE SOUND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2014
Last Update Date: 11/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 RAYNOR RD
RIDGE NY
11961-1900
US

IV. Provider business mailing address

114 RAYNOR RD
RIDGE NY
11961-1900
US

V. Phone/Fax

Practice location:
  • Phone: 631-205-9059
  • Fax: 631-910-2066
Mailing address:
  • Phone: 631-205-9059
  • Fax: 631-910-2066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number001912-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number14000017217
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number15000012121
License Number StateNY

VIII. Authorized Official

Name: JENNIFER AUER
Title or Position: OWNER
Credential: AUD
Phone: 631-205-9059