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General NPI Number Information
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NPI Number | 1750539888
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY & HEARING CENTER LLC
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 579 CRANBURY RD SUITE E
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816
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Country | US
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Telephone | 732-266-3308
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Fax |
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Provider Business Mailing Address
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Address Line | 10 BUTTONWOOD DR.
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816
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Country | US
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Telephone | 732-266-3308
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Fax |
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | AMIRA JACOB
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Credential | AU.D.
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Telephone | 732-266-3308
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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 | 41YA00063000
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License Number State | NJ
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