MEDICARE: MOLLY RUSCHAU

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	03147	OH

General Provider Information

NPI Number	:	1285271742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOLLY RUSCHAU

Provider Business Mailing Address
First Line	:	115 US HIGHWAY 46 STE G51
Second Line	:
City	:	MOUNTAIN LAKES
State	:	NJ
Zip	:	07046-1676
Country	:	US
Telephone Number	:	973-588-7266
Fax Number	:	973-588-7268

Provider Business Practice Location Address
First Line	:	21245 LORAIN RD STE 202
Second Line	:
City	:	FAIRVIEW PARK
State	:	OH
Zip	:	44126-2140
Country	:	US
Telephone Number	:	440-333-5220
Fax Number	:

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

Provider Enumeration Date	:	12/04/2019
Last Update Date	:	12/04/2019

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Directions to “ MOLLY RUSCHAU ” Practice Location

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