Provider Demographics
NPI:1083645543
Name:CERTIFIED AUDIOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:CERTIFIED AUDIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST/HEARING AID DISP
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEESNER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:609-926-0700
Mailing Address - Street 1:222 NEW ROAD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1299
Mailing Address - Country:US
Mailing Address - Phone:609-926-0700
Mailing Address - Fax:609-926-4870
Practice Address - Street 1:222 NEW RD
Practice Address - Street 2:SUITE 301
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1299
Practice Address - Country:US
Practice Address - Phone:609-926-0700
Practice Address - Fax:609-926-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00064200237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7939507Medicaid
NJP2162112OtherOXFORD
NJ1140429OtherNJ HEALTH
NJ2131888OtherAETNA
NJ7939507Medicaid
NJ2131888OtherAETNA