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General NPI Number Information
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NPI Number | 1104151703
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Entity Type | Organization
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Legal Business Name | SOUTHERN TIER HEARING SERVICES PLLC
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Dates
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Enumeration Date | 10/15/2009
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 231 MAIN ST SUITE 1
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City | VESTAL
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State | NY
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Zip | 13850-1523
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Country | US
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Telephone | 607-205-1041
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Fax | 607-239-5156
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Provider Business Mailing Address
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Address Line | 231 MAIN ST SUITE 1
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City | VESTAL
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State | NY
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Zip | 13850-1523
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Country | US
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Telephone | 607-205-1041
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Fax | 607-239-5156
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | DAVID ARI GLASER
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Credential | M.S.
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Telephone | 607-205-1041
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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 | 002018-1
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License Number State | NY
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