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General NPI Number Information
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NPI Number | 1396758314
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Entity Type | Organization
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Legal Business Name | TROY AUDIOLOGY, PC
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2200 BURDETT AVE 105
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City | TROY
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State | NY
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Zip | 12180-2451
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Country | US
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Telephone | 518-272-7323
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Fax | 518-272-7243
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Provider Business Mailing Address
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Address Line | 2200 BURDETT AVE 105
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City | TROY
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State | NY
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Zip | 12180-2451
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Country | US
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Telephone | 518-272-7323
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Fax | 518-272-7243
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTOPHER PAUL QUENELLE
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Credential | MA, CCC
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Telephone | 518-943-0591
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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 | 15000010665
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License Number State | NY
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