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NPI Code Detail

MEDICARE: CHAMPLAIN VALLEY AUDIOLOGY, PLLC

MEDICARE: CHAMPLAIN VALLEY AUDIOLOGY, PLLC
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
1237600000XAudiologist-Hearing Aid Fitter14000001179NY
2231H00000XAudiologist1424NY

General Provider Information

NPI Number : 1215104153
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHAMPLAIN VALLEY AUDIOLOGY, PLLC
Provider Business Mailing Address
First Line : 176 US OVAL
Second Line : SUITE 3
City : PLATTSBURGH
State : NY
Zip : 12903-3900
Country : US
Telephone Number : 518-324-5707
Fax Number : 518-324-5726
Provider Business Practice Location Address
First Line : 176 US OVAL
Second Line : SUITE 3
City : PLATTSBURGH
State : NY
Zip : 12903-3900
Country : US
Telephone Number : 518-324-5707
Fax Number : 518-324-5726
Authorized Official
Title or Position : OWNER
Name : DR. SHARON JOY MACNER
Credential : AU.D.
Telephone Number : 518-324-5707
Provider Enumeration Date : 05/09/2008
Last Update Date : 03/20/2012

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Directions to “CHAMPLAIN VALLEY AUDIOLOGY, PLLC ” Practice Location

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