=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801251699
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUDIOLOGY ASSOCIATES OF WESTCHESTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2015
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 550 MAMARONECK AVE STE 407
-----------------------------------------------------
City | HARRISON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10528-1609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-949-0034
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 550 MAMARONECK AVE STE 407
-----------------------------------------------------
City | HARRISON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10528-1609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-949-0034
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING MANAGER
-----------------------------------------------------
Name | MS. ALICIA RIVERA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 914-949-0034
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 15000025541
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------