Healthcare Provider Details

I. General information

NPI: 1164516308
Provider Name (Legal Business Name): LINDA E RONIS-KASS AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WALNUT ST 18TH FLOOR
PHILADELPHIA PA
19107-5176
US

IV. Provider business mailing address

800 WALNUT ST 18TH FLOOR
PHILADELPHIA PA
19107-5176
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-8180
  • Fax:
Mailing address:
  • Phone: 215-829-5180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT000833L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: