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General NPI Number Information
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NPI Number | 1841540986
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Entity Type | Organization
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Legal Business Name | GARDEN STATE HEARING AID CTR. INC
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 121 N BLACK HORSE PIKE
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City | RUNNEMEDE
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State | NJ
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Zip | 08078-1629
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Country | US
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Telephone | 856-881-8900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36 24 GEORGETOWN RD
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City | GLASSBORO
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State | NJ
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Zip | 08028-0036
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DOROTHY L IVEY
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Credential |
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Telephone | 856-881-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number |
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License Number State |
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