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NPI Code Detail

MEDICARE: EARLAB INC

MEDICARE: EARLAB 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
1231H00000XAudiologist41YB00001100NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12K2216OTHERNJHEALTHNET
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3514357OTHERNJAETNA
4BS-593OTHERNJOXFORD

General Provider Information

NPI Number : 1306049234
Entity Type Code : Organization
Provider Name (Legal Business Name) : EARLAB INC
Provider Business Mailing Address
First Line : 11-26 SADDLE RIVER RD
Second Line :
City : FAIR LAWN
State : NJ
Zip : 07410-5634
Country : US
Telephone Number : 201-796-3131
Fax Number : 201-796-9017
Provider Business Practice Location Address
First Line : 11-26 SADDLE RIVER RD
Second Line :
City : FAIR LAWN
State : NJ
Zip : 07410-5634
Country : US
Telephone Number : 201-796-3131
Fax Number : 201-796-9017
Authorized Official
Title or Position : AUDIOLOGIST
Name : DR. GARY D HILT
Credential : AUD
Telephone Number : 201-796-3131
Provider Enumeration Date : 06/07/2007
Last Update Date : 09/24/2007

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Directions to “EARLAB INC ” Practice Location

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