Healthcare Provider Details

I. General information

NPI: 1700824349
Provider Name (Legal Business Name): EAST RIDGE HEARING & SPEECH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CANAL LANDING BLVD., SUITE 10
ROCHESTER NY
14626-5109
US

IV. Provider business mailing address

101 CANAL LANDING BLVD STE 10
ROCHESTER NY
14626-5109
US

V. Phone/Fax

Practice location:
  • Phone: 585-227-6543
  • Fax: 585-413-3100
Mailing address:
  • Phone: 585-227-6543
  • Fax: 585-413-3100

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: DR. PETER HART
Title or Position: VICE PRESIDENT
Credential: AUD
Phone: 585-266-4130