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General NPI Number Information
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NPI Number | 1588935670
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Entity Type | Organization
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Legal Business Name | ADVANCED HEARING GROUP
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Dates
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Enumeration Date | 01/20/2012
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | 8600 SNOWDEN RIVER PKWY STE 309
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City | COLUMBIA
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State | MD
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Zip | 21045
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Country | US
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Telephone | 877-361-0100
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Fax | 410-582-8992
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Provider Business Mailing Address
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Address Line | 8600 SNOWDEN RIVER PKWY STE 309
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City | COLUMBIA
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State | MD
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Zip | 21045-1986
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Country | US
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Telephone | 877-361-0100
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Fax | 410-582-8992
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Authorized Official
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Title or Position | PRESIDENT
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Name | SANJAY SRIVASTAVA
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Credential |
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Telephone | 410-718-3328
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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 | 00879
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License Number State | MD
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