=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124413828
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILANO QUALITY HEARING AID CENTER INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2015
-----------------------------------------------------
Last Update Date | 03/31/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 209 W MAIN ST
-----------------------------------------------------
City | RIVERHEAD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11901-2828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-727-7676
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 209 W MAIN ST
-----------------------------------------------------
City | RIVERHEAD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11901-2828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MRS. LISA MICHELLE MILANO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 631-727-7676
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number | 14000032784
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------