=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356818801
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUDICUS, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2018
-----------------------------------------------------
Last Update Date | 09/06/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 130 W 29TH ST FL 11
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-971-0451
-----------------------------------------------------
Fax | 888-498-5366
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 130 W 29TH ST FL 11
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10001-5312
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-971-0451
-----------------------------------------------------
Fax | 888-498-5366
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | PATRICK FREULER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 917-287-6953
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------