Healthcare Provider Details

I. General information

NPI: 1659409332
Provider Name (Legal Business Name): SMITHTOWN HEARING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E MAIN ST
SMITHTOWN NY
11787-2900
US

IV. Provider business mailing address

300 E MAIN ST
SMITHTOWN NY
11787-2900
US

V. Phone/Fax

Practice location:
  • Phone: 631-265-3727
  • Fax:
Mailing address:
  • Phone: 631-265-3727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number15000005906
License Number StateNY

VIII. Authorized Official

Name: RITA LORENTZ
Title or Position: PRESIDENT
Credential: MA
Phone: 631-265-3727