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General NPI Number Information
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NPI Number | 1316088909
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Entity Type | Organization
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Legal Business Name | ATLANTIC AUDIOLOGY, LLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 19110 MONTGOMERY VILLAGE AVE SUITE 120
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City | GAITHERSBURG
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State | MD
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Zip | 20886-3702
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Country | US
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Telephone | 301-977-6317
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Fax |
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Provider Business Mailing Address
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Address Line | 224 OLIVER HEIGHTS RD
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5073
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Country | US
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Telephone | 310-742-7779
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENIFER CUSHING
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Credential | AU.D.
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Telephone | 301-742-7779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 01075
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License Number State | MD
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