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General NPI Number Information
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NPI Number | 1053445353
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Entity Type | Organization
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Legal Business Name | PELHAM AUDIOLOGY ASSOC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 1934 WILLIAMSBRIDGE RD
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City | BRONX
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State | NY
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Zip | 10461-1638
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Country | US
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Telephone | 718-822-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 1934 WILLIAMSBRIDGE RD
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City | BRONX
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State | NY
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Zip | 10461-1638
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Country | US
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Telephone | 718-822-4100
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DEBBY GOLDENBERG
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Credential |
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Telephone | 718-224-6100
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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 | 586359
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License Number State | NY
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