Provider Demographics
NPI:1033394309
Name:HOFSTRA FAMILY HEARING CENTER INC
Entity Type:Organization
Organization Name:HOFSTRA FAMILY HEARING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES HOFSTRA FAMILY HEARING
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HOFSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-385-9402
Mailing Address - Street 1:12705 SO RIDGELAND AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463
Mailing Address - Country:US
Mailing Address - Phone:708-385-9402
Mailing Address - Fax:708-385-9403
Practice Address - Street 1:12705 SO RIDGELAND AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463
Practice Address - Country:US
Practice Address - Phone:708-385-9402
Practice Address - Fax:708-385-9403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2898237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty