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General NPI Number Information
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NPI Number | 1760934954
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Entity Type | Organization
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Legal Business Name | ADVANCED AUDIOLOGY OF NY II PC
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 102 E ROUTE 59
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City | NANUET
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State | NY
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Zip | 10954-2910
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Country | US
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Telephone | 845-501-7339
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Fax |
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Provider Business Mailing Address
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Address Line | 102 E ROUTE 59
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City | NANUET
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State | NY
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Zip | 10954-2910
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Country | US
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Telephone | 845-501-7339
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Fax |
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Authorized Official
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Title or Position | CHIEF AUDIOLOGIST
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Name | JASEN RUIZ
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Credential |
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Telephone | 18455017339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number |
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License Number State |
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