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General NPI Number Information
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NPI Number | 1013118751
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY CONSULTANTS OF CORTLAND, PC
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9 CHURCH ST
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City | CORTLAND
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State | NY
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Zip | 13045-2709
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Country | US
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Telephone | 607-756-8915
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Fax | 607-756-1820
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Provider Business Mailing Address
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Address Line | 9 CHURCH ST
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City | CORTLAND
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State | NY
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Zip | 13045-2709
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Country | US
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Telephone | 607-756-8915
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Fax | 607-756-1820
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Authorized Official
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Title or Position | CEO
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Name | DR. JUDITH A. MCMAHON
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Credential | AU.D
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Telephone | 607-756-8915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 001450-1
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License Number State | NY
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