MEDICARE: DESERT SOUNDS AUDIOLOGY AND HEARING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237600000X	Audiologist-Hearing Aid Fitter	HAD1807	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	640004720	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01089518	OTHER	AZ	ASHA CERTIFICATION
2	AZ0901110	OTHER	AZ	BLUE CROSS BLUE SHIELD OF ARIZONA
4	BHAD1807	OTHER	AZ	STATE LICENSE

General Provider Information

NPI Number	:	1023215118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DESERT SOUNDS AUDIOLOGY AND HEARING

Provider Business Mailing Address
First Line	:	6124 E BROWN RD
Second Line	:	STE. 102
City	:	MESA
State	:	AZ
Zip	:	85205-4959
Country	:	US
Telephone Number	:	480-497-3285
Fax Number	:	480-833-2513

Provider Business Practice Location Address
First Line	:	6124 E BROWN RD
Second Line	:	STE. 102
City	:	MESA
State	:	AZ
Zip	:	85205-4959
Country	:	US
Telephone Number	:	480-497-3285
Fax Number	:	480-833-2513

Authorized Official
Title or Position	:	OWNER AUDIOLOGIST
Name	:	GABRIELLE SADOWSKY
Credential	:	AU.D.
Telephone Number	:	480-497-3285

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	08/17/2015

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Directions to “DESERT SOUNDS AUDIOLOGY AND HEARING ” Practice Location

Language	Start Address	Practice Location

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