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General NPI Number Information
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NPI Number | 1902019755
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Entity Type | Organization
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Legal Business Name | AUDIOLOGY ASSOCIATES OF FREEHOLD, P.C.
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 07/07/2008
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Provider Practice Location Address
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Address Line | 55-77 SCHANCK RD STE A-6
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City | FREEHOLD
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State | NJ
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Zip | 07728-2963
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Country | US
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Telephone | 732-462-1413
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Fax | 732-462-1771
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Provider Business Mailing Address
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Address Line | 55-77 SCHANCK RD STE A-6
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City | FREEHOLD
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State | NJ
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Zip | 07728-2963
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Country | US
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Telephone | 732-462-1413
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Fax | 732-462-1771
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Authorized Official
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Title or Position | AUDIOLOGIST
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Name | DR. ROBERT M. DISOGRA
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Credential | AU.D.
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Telephone | 732-462-1413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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