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NPI Code Detail

MEDICARE: REBECCA C MERVINE AUD, CCC-A

MEDICARE: REBECCA C MERVINE AUD, CCC-A
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
1231H00000XAudiologist0011428-1NY
2237600000XAudiologist-Hearing Aid Fitter14000017564NY

General Provider Information

NPI Number : 1174586663
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA C MERVINE AUD, CCC-A
Provider Business Mailing Address
First Line : 1000 ELMWOOD AVE
Second Line : SUITE #400
City : ROCHESTER
State : NY
Zip : 14620-3042
Country : US
Telephone Number : 585-271-0680
Fax Number : 585-442-4114
Provider Business Practice Location Address
First Line : 1000 ELMWOOD AVE
Second Line : SUITE #400
City : ROCHESTER
State : NY
Zip : 14620-3042
Country : US
Telephone Number : 585-271-0680
Fax Number : 585-442-4114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2006
Last Update Date : 09/11/2025

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