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General NPI Number Information
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NPI Number | 1598768582
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Entity Type | Individual
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Provider Name | SUSAN RUTH HOLLAR AU.D
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Gender | Female
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 10/05/2009
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Provider Practice Location Address
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Address Line | 105 MARYS AVE DEPARTMENT OF AUDIOLOGY
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City | KINGSTON
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State | NY
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Zip | 12401-5848
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Country | US
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Telephone | 845-334-3121
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Fax | 845-334-4789
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Provider Business Mailing Address
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Address Line | 105 MARYS AVE DEPT OF AUDIOLOGY
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City | KINGSTON
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State | NY
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Zip | 12401-5848
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Country | US
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Telephone | 845-334-3121
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Fax | 845-334-4789
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 000949
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 140000021026
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License Number State | NY
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