=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023696192
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AHC ILH LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2021
-----------------------------------------------------
Last Update Date | 08/09/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 191 MAIN ST
-----------------------------------------------------
City | PORT WASHINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11050-3242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-883-9311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 191 MAIN ST
-----------------------------------------------------
City | PORT WASHINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11050-3242
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-883-9311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALISON HOFFMANN
-----------------------------------------------------
Credential | AUD
-----------------------------------------------------
Telephone | 516-883-9311
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------