MEDICARE: JORGE S. ZAVALA, AU.D., INC.

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	AT006195	PA

General Provider Information

NPI Number	:	1215368212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORGE S. ZAVALA, AU.D., INC.

Provider Business Mailing Address
First Line	:	917 JENIFER RD
Second Line	:
City	:	HORSHAM
State	:	PA
Zip	:	19044-1021
Country	:	US
Telephone Number	:	646-351-3686
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 E JOHNSON HWY
Second Line	:
City	:	NORRISTOWN
State	:	PA
Zip	:	19401-3110
Country	:	US
Telephone Number	:	610-277-3336
Fax Number	:	610-277-8255

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JORGE SPENCER ZAVALA
Credential	:	AU.D.
Telephone Number	:	646-351-3686

Provider Enumeration Date	:	12/02/2013
Last Update Date	:	06/17/2022

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