=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891745758
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BUFFALO HEARING & SPEECH CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/11/2006
-----------------------------------------------------
Last Update Date | 03/28/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 50 E NORTH ST
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14203-1002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-885-8318
-----------------------------------------------------
Fax | 716-885-0229
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 50 E NORTH ST
-----------------------------------------------------
City | BUFFALO
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14203-1002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 716-885-8318
-----------------------------------------------------
Fax | 716-885-0229
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/CEO
-----------------------------------------------------
Name | MR. JOSEPH COZZO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 716-885-8318
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 237600000X
-----------------------------------------------------
Taxonomy Name | Audiologist-Hearing Aid Fitter
-----------------------------------------------------
License Number | 1401201R
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number | 1401201R
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251300000X
-----------------------------------------------------
Taxonomy Name | Local Education Agency (LEA)
-----------------------------------------------------
License Number | 1401201R
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #5
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 1401201R
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------