Healthcare Provider Details

I. General information

NPI: 1386647360
Provider Name (Legal Business Name): HELENE LEVENFUS GOLDSTEIN AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5010 MAYFIELD RD STE 116
LYNDHURST OH
44124-2611
US

IV. Provider business mailing address

5010 MAYFIELD RD STE 116
LYNDHURST OH
44124-2611
US

V. Phone/Fax

Practice location:
  • Phone: 216-381-5011
  • Fax: 216-381-9277
Mailing address:
  • Phone: 216-381-5011
  • Fax: 216-381-9277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-00280
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA-00280
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: