Healthcare Provider Details

I. General information

NPI: 1184776759
Provider Name (Legal Business Name): AUDIOLOGY & HEARING CENTERS OF NEPA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 03/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 SPRUCE ST BANK TOWER - 7TH FLOOR
SCRANTON PA
18503-1400
US

IV. Provider business mailing address

321 SPRUCE ST BANK TOWER - 7TH FLOOR
SCRANTON PA
18503-1400
US

V. Phone/Fax

Practice location:
  • Phone: 570-343-7710
  • Fax: 570-343-7734
Mailing address:
  • Phone: 570-343-7710
  • Fax: 570-343-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberAT000012L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberAT000012L
License Number StatePA

VIII. Authorized Official

Name: DR. DENISE PRISLUPSKI
Title or Position: AUDIOLOGIST
Credential: AU.D.
Phone: 570-343-7710