MEDICARE: ASSOCIATED AUDIOLOGIC CONSULTANTS,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	41YA00045200	NJ
2	237600000X	Audiologist-Hearing Aid Fitter	AT000228L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508921701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED AUDIOLOGIC CONSULTANTS,INC

Provider Business Mailing Address
First Line	:	1920 CHESTNUT ST
Second Line	:	SUITE 200
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-0550
Fax Number	:	215-561-1235

Provider Business Practice Location Address
First Line	:	1920 CHESTNUT ST
Second Line	:	SUITE 200
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-0550
Fax Number	:	215-561-1235

Authorized Official
Title or Position	:	CEO
Name	:	MR. EDWARD W KEELS
Credential	:	MACCCA
Telephone Number	:	215-561-0550

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	05/01/2009

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Directions to “ASSOCIATED AUDIOLOGIC CONSULTANTS,INC ” Practice Location

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