MEDICARE: MADELINE MARIE NEW AUD

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	231H00000X	Audiologist	A.02276	OH

General Provider Information

NPI Number	:	1992323109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELINE MARIE NEW AUD

Provider Business Mailing Address
First Line	:	1932 NILES CORTLAND RD NE STE H
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1055
Country	:	US
Telephone Number	:	330-841-2386
Fax Number	:	330-856-2530

Provider Business Practice Location Address
First Line	:	1932 NILES CORTLAND RD NE STE H
Second Line	:
City	:	WARREN
State	:	OH
Zip	:	44484-1055
Country	:	US
Telephone Number	:	330-841-2386
Fax Number	:	330-856-2530

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

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	04/23/2026

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Directions to “ MADELINE MARIE NEW AUD” Practice Location

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