Healthcare Provider Details

I. General information

NPI: 1952300287
Provider Name (Legal Business Name): KERI L OPPENHEIMER MS, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 WANTAGH AVE
WANTAGH NY
11793-2136
US

IV. Provider business mailing address

1181 WANTAGH AVE
WANTAGH NY
11793-2136
US

V. Phone/Fax

Practice location:
  • Phone: 516-785-3292
  • Fax: 516-785-3296
Mailing address:
  • Phone: 516-785-3292
  • Fax: 516-785-3296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number001657-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: