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General NPI Number Information
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NPI Number | 1508458753
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Entity Type | Organization
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Legal Business Name | WISE AUDIOLOGY PC
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Dates
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Enumeration Date | 02/09/2021
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Last Update Date | 02/09/2021
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Provider Practice Location Address
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Address Line | 9811 QUEENS BLVD STE 1D
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City | REGO PARK
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State | NY
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Zip | 11374-3309
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Country | US
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Telephone | 718-554-0017
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Fax | 718-440-3575
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Provider Business Mailing Address
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Address Line | 9811 QUEENS BLVD STE 1D
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City | REGO PARK
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State | NY
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Zip | 11374-3309
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Country | US
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Telephone | 718-554-0017
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Fax | 718-440-3575
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Authorized Official
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Title or Position | PRESIDENT/AUDIOLOGIST
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Name | DR. SOFYA SHLAFMAN
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Credential | AUD
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Telephone | 718-554-0017
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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 |
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License Number State |
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