Provider Demographics
NPI:1053478487
Name:HOUSEOFHEARINGAIDSINC
Entity Type:Organization
Organization Name:HOUSEOFHEARINGAIDSINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GROB
Authorized Official - Suffix:
Authorized Official - Credentials:HEARINGAIDSPECIALIST
Authorized Official - Phone:732-363-5991
Mailing Address - Street 1:1000 HIGHWAY 70
Mailing Address - Street 2:LEISURE SQUARE MALL SUITE 14
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-363-5991
Mailing Address - Fax:732-364-8590
Practice Address - Street 1:1000 HIGHWAY 70
Practice Address - Street 2:LEISURE SQUARE MALL SUITE 14
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-363-5991
Practice Address - Fax:732-364-8590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00037400332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0039888Medicaid