Healthcare Provider Details

I. General information

NPI: 1780949016
Provider Name (Legal Business Name): HEARING SPECIALISTS OF YARDLEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

24 SOUTH MAIN STREET
YARDLEY PA
19067
US

IV. Provider business mailing address

24 SOUTH MAIN STREET
YARDLEY PA
19067
US

V. Phone/Fax

Practice location:
  • Phone: 215-493-2333
  • Fax: 215-784-9729
Mailing address:
  • Phone: 215-493-2333
  • Fax: 215-784-9729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAT-000188L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SUSAN E HARRISON
Title or Position: OWNER-CERTIFIED AUDIOLOGIST
Credential: M.S.,CCA-A, FAAA
Phone: 215-493-2333