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General NPI Number Information
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NPI Number | 1194052563
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Entity Type | Individual
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Provider Name | ANGELA M LALLA AU.D.
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Gender | Female
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Dates
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Enumeration Date | 11/05/2009
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Last Update Date | 11/05/2009
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Provider Practice Location Address
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Address Line | 318 RIDGE STREET
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City | GLENS SALLAS
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State | NY
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Zip | 12801
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Country | US
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Telephone | 518-581-7408
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Fax |
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Provider Business Mailing Address
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Address Line | 44 HATHORN BLVD.
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866
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Country | US
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Telephone | 518-581-7408
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Fax | 518-671-1490
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 001117-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 14000002755
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License Number State | NY
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