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General NPI Number Information
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NPI Number | 1245397462
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Entity Type | Organization
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Legal Business Name | DELAWARE AUDIOLOGY GROUP, P.C.
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1083 DELAWARE AVE SUITE 200
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City | BUFFALO
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State | NY
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Zip | 14209-1635
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Country | US
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Telephone | 716-886-6462
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Fax | 716-886-6465
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Provider Business Mailing Address
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Address Line | 1083 DELAWARE AVE SUITE 200
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City | BUFFALO
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State | NY
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Zip | 14209-1635
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Country | US
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Telephone | 716-886-6462
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Fax | 716-886-6465
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD F. KOCH
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Credential | AU.D.
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Telephone | 716-886-6462
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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 | 00835
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License Number State | NY
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