Healthcare Provider Details

I. General information

NPI: 1841746310
Provider Name (Legal Business Name): K. OPPENHEIMER AUDIOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2016
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: 515-785-3296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. KERI L OPPENHEIMER
Title or Position: AUDIOLOGIST/OWNER
Credential: M.S.
Phone: 516-785-3292