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General NPI Number Information
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NPI Number | 1215230040
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Entity Type | Organization
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Legal Business Name | ELITE AUDIOLOGY PC
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 12/16/2010
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Provider Practice Location Address
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Address Line | 10812 72ND AVE 3RD FLOOR
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City | FOREST HILLS
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State | NY
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Zip | 11375-7079
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Country | US
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Telephone | 917-459-8968
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Fax |
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Provider Business Mailing Address
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Address Line | 8912 AUBREY AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7930
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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 | AUDIOLOGIST
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Name | GREGORY ABRAMOV
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Credential |
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Telephone | 917-459-8968
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 002166-1
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License Number State | NY
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