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General NPI Number Information
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NPI Number | 1619145042
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Entity Type | Organization
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Legal Business Name | MAE AUDIOLOGICAL SERVICES, INC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 802 LOWRY AVE
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City | JEANNETTE
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State | PA
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Zip | 15644-2661
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Country | US
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Telephone | 724-527-2228
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Fax | 724-527-8888
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Provider Business Mailing Address
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Address Line | 802 LOWRY AVE
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City | JEANNETTE
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State | PA
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Zip | 15644-2661
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Country | US
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Telephone | 724-527-2228
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Fax | 724-527-8888
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Authorized Official
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Title or Position | PRESIDENT
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Name | MONICA A. EREDITARIO
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Credential | M.S.
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Telephone | 724-527-2228
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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 | AT000443L
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License Number State | PA
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