Healthcare Provider Details

I. General information

NPI: 1255431318
Provider Name (Legal Business Name): INTERSTATE HEARING AID SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 LUDLOW ST SUITE 602
YONKERS NY
10705-1947
US

IV. Provider business mailing address

45 LUDLOW ST SUITE 602
YONKERS NY
10705-1947
US

V. Phone/Fax

Practice location:
  • Phone: 914-375-7591
  • Fax: 914-375-2994
Mailing address:
  • Phone: 914-375-7591
  • Fax: 914-375-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number15000006959
License Number StateNY

VIII. Authorized Official

Name: MR. JOHN H TREGLIA
Title or Position: PRESIDENT
Credential:
Phone: 914-375-7591