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General NPI Number Information
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NPI Number | 1942581608
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Entity Type | Organization
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Legal Business Name | JACKSON HEARING AIDS, LLC
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Dates
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Enumeration Date | 09/07/2011
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 177 FRANKLIN CORNER RD SUITE 1-B
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-2548
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Country | US
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Telephone | 609-895-1666
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Fax |
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Provider Business Mailing Address
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Address Line | 27 N BAKER DR
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City | JACKSON
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State | NJ
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Zip | 08527-3962
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Country | US
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Telephone | 732-987-4218
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Fax | 732-987-4219
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Authorized Official
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Title or Position | OWNER
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Name | MS. JOANNE LONG ROSENBERG
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Credential | M.A.
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Telephone | 732-987-4218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332S00000X
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Taxonomy Name | Hearing Aid Equipment
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License Number | 41YA00077300
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License Number State | NJ
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