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General NPI Number Information
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NPI Number | 1487802880
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Entity Type | Organization
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Legal Business Name | RIVERSIDE AUDIOLOGY, LLC
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 161 RIVERSIDE DR STE M10
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City | BINGHAMTON
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State | NY
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Zip | 13905-4112
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Country | US
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Telephone | 607-770-9012
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Fax | 607-797-3879
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Provider Business Mailing Address
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Address Line | 161 RIVERSIDE DR STE M10
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City | BINGHAMTON
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State | NY
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Zip | 13905-4112
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Country | US
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Telephone | 607-770-9012
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Fax | 607-797-3879
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | MARIAN GOLDSMITH
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Credential |
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Telephone | 607-341-2026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 0001331
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License Number State | NY
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