Healthcare Provider Details

I. General information

NPI: 1588662811
Provider Name (Legal Business Name): BRIAN T HARRINGTON AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 03/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 MONTGOMERY AVE MAIN LINE AUDIOLOGY CONSULTANTS, PC
NARBERTH PA
19072
US

IV. Provider business mailing address

916 MONTGOMERY AVE MAIN LINE AUDIOLOGY CONSULTANTS, PC
NARBERTH PA
19072
US

V. Phone/Fax

Practice location:
  • Phone: 610-667-3277
  • Fax: 610-667-1662
Mailing address:
  • Phone: 610-667-3277
  • Fax: 610-667-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAT005877
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: