MEDICARE: L. DOERFLER AUDIOLOGY ASSOC. P.C.

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	D00549	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	GPCE8653	OTHER	PA	RAILROAD MEDICARE GROUP#

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0420476	OTHER	PA	UMWA HEARING AID&REP.#
2	209368	OTHER	PA	UPMC GROUP PROVIDER #
3	0001326882	OTHER	PA	BLUE SHIELD GROUP NUMBER
4	27026	OTHER	PA	HEALTH ASSURANCE/ADVANTRA
5	129034	OTHER	PA	UMWA TESTING GROUP #

General Provider Information

NPI Number	:	1609849942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L. DOERFLER AUDIOLOGY ASSOC. P.C.

Provider Business Mailing Address
First Line	:	433 FRYE FARM RD
Second Line	:	SUITE 5
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-539-3750
Fax Number	:	724-539-3751

Provider Business Practice Location Address
First Line	:	433 FRYE FARM RD
Second Line	:	SUITE 5
City	:	GREENSBURG
State	:	PA
Zip	:	15601-6480
Country	:	US
Telephone Number	:	724-539-3750
Fax Number	:	724-539-3751

Authorized Official
Title or Position	:	PRES/AUDIOLOGIST
Name	:	PAUL RICHARD PLUCKER
Credential	:	CCC-A,
Telephone Number	:	724-539-3750

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	08/22/2020

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