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General NPI Number Information
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NPI Number | 1396780656
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Entity Type | Organization
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Legal Business Name | PARK RIDGE HEARING CENTER
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 121 ERIE CANAL DR SUITE E
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City | ROCHESTER
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State | NY
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Zip | 14626-4605
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Country | US
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Telephone | 585-227-9920
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Fax | 585-225-6574
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Provider Business Mailing Address
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Address Line | 121 ERIE CANAL DR SUITE E
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City | ROCHESTER
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State | NY
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Zip | 14626-4605
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Country | US
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Telephone | 585-227-9920
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Fax | 585-225-6574
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Authorized Official
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Title or Position | SPECIALIST
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Name | MR. JOHN CRANDALL
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Credential | BC-HIS
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Telephone | 585-227-9920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 15000007423
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License Number State | NY
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