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General NPI Number Information
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NPI Number | 1790999464
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Entity Type | Organization
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Legal Business Name | ADVANCED AUDIOLOGY SERVICES PC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 2001 5TH AVE TROY MEDICAL PLAZA
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City | TROY
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State | NY
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Zip | 12180-3340
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Country | US
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Telephone | 518-270-5802
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Fax | 518-270-5807
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Provider Business Mailing Address
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Address Line | 2001 5TH AVE TROY MEDICAL PLAZA
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City | TROY
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State | NY
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Zip | 12180-3340
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Country | US
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Telephone | 518-270-5802
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Fax | 518-270-5807
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT N. FERGUSON
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Credential | MA
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Telephone | 518-270-5802
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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 | 000315-1
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License Number State | NY
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