=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932611258
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A&A HEARING GROUP, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2017
-----------------------------------------------------
Last Update Date | 12/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4000 OLD COURT RD STE 202
-----------------------------------------------------
City | PIKESVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21208-2894
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-580-1222
-----------------------------------------------------
Fax | 410-580-9114
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19110 MONTGOMERY VILLAGE AVE STE 120
-----------------------------------------------------
City | MONTGOMERY VILLAGE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20886-3706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/AUDIOLOGIST
-----------------------------------------------------
Name | ROSS EMERSON CUSHING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 301-358-1833
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 231H00000X
-----------------------------------------------------
Taxonomy Name | Audiologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------