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General NPI Number Information
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NPI Number | 1134384357
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Entity Type | Individual
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Provider Name | TRACIE DAWN EDWARDS HEARING AID SPECIALI
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Gender | Female
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Dates
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Enumeration Date | 07/28/2008
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Last Update Date | 03/11/2009
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Provider Practice Location Address
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Address Line | 7760 ROUTE 417 W
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City | BOLIVAR
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State | NY
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Zip | 14715
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Country | US
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Telephone | 585-928-1657
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Fax |
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Provider Business Mailing Address
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Address Line | 7760 RT 417 WEST
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City | BOLIVAR
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State | NY
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Zip | 14715
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Country | US
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Telephone | 585-928-1657
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 15000016138
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | F03199
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License Number State | PA
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