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General NPI Number Information
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NPI Number | 1134414402
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE AUDIOLOGY P.C.
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 88 NEW DORP PLZ S SUITE 105
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2902
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Country | US
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Telephone | 718-980-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 88 NEW DORP PLZ S SUITE 105
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EVAN BERNSTEIN
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Credential |
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Telephone | 718-980-7700
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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 | 002193-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 002915-1
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License Number State | NY
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