MEDICARE: DR. GARY THORNE AU.D.

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	25MG00095500	NJ

General Provider Information

NPI Number	:	1033254958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY THORNE AU.D.

Provider Business Mailing Address
First Line	:	851 ROUTE 73 N STE B
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-1275
Country	:	US
Telephone Number	:	856-985-7770
Fax Number	:

Provider Business Practice Location Address
First Line	:	851 ROUTE 73 N STE B
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-1275
Country	:	US
Telephone Number	:	856-985-7770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	05/30/2023

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