=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033659339
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MORABITO HEARING AID CENTER LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2017
-----------------------------------------------------
Last Update Date | 03/06/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 CANAL LANDING BLVD SUITE 5
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14626-5111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-360-2540
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 CANAL LANDING BLVD SUITE 5
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14626-5111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-360-2540
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANDREW FRANK MORABITO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 585-360-2540
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number | 14000018507
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------