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General NPI Number Information
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NPI Number | 1417122888
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Entity Type | Organization
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Legal Business Name | DOMINICK SERVEDIO, AU.D, P.C.
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 200 W 57TH ST SUITE 910
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City | NEW YORK
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State | NY
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Zip | 10019-3211
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Country | US
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Telephone | 917-441-6094
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Fax | 917-441-6102
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Provider Business Mailing Address
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Address Line | 200 W 57TH ST SUITE 910
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City | NEW YORK
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State | NY
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Zip | 10019-3211
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Country | US
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Telephone | 917-441-6094
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Fax | 917-441-6102
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Authorized Official
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Title or Position | AUDIOLOGIST/ OWNER
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Name | DOMINICK SERVEDIO
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Credential | AU.D
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Telephone | 917-441-6094
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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 | 1080
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License Number State | NY
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