Healthcare Provider Details

I. General information

NPI: 1649551367
Provider Name (Legal Business Name): PA CENTER FOR HEARING AND BALANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2011
Last Update Date: 07/19/2022
Certification Date: 07/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S STATE RD STE 201
SPRINGFIELD PA
19064-1232
US

IV. Provider business mailing address

130 S STATE RD STE 201
SPRINGFIELD PA
19064-1232
US

V. Phone/Fax

Practice location:
  • Phone: 610-438-5203
  • Fax: 484-470-6001
Mailing address:
  • Phone: 610-438-5203
  • Fax: 484-470-6001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberD00973
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberD00973
License Number StatePA

VIII. Authorized Official

Name: DR. LILIANA C PICCININI
Title or Position: AUDIOLOGIST
Credential: AUD
Phone: 610-438-5203