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General NPI Number Information
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NPI Number | 1629412754
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Entity Type | Organization
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Legal Business Name | ALK HEARING LLC
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 8715 37TH AVE SUITE D
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7701
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Country | US
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Telephone | 718-507-5200
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Fax | 718-507-7879
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Provider Business Mailing Address
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Address Line | 8715 37TH AVE SUITE D
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-7701
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Country | US
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Telephone | 718-507-5200
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Fax | 718-507-7879
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Authorized Official
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Title or Position | OWNER
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Name | DR. AVIVA LISA KAGAN
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Credential | AU.D
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Telephone | 516-295-9054
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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 | 001536
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License Number State | NY
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