Healthcare Provider Details

I. General information

NPI: 1659892396
Provider Name (Legal Business Name): NORTHEAST HEARING SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 AIRPORT RD STE 139
HAZLE TOWNSHIP PA
18202-3361
US

IV. Provider business mailing address

426 AIRPORT RD STE 139
HAZLE TOWNSHIP PA
18202-3361
US

V. Phone/Fax

Practice location:
  • Phone: 570-459-1400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberD01228
License Number StatePA

VIII. Authorized Official

Name: NEVIN G BALLIET
Title or Position: PRESIDENT
Credential: BC-HIS
Phone: 570-459-1400