Provider Demographics
NPI:1114109436
Name:AUDIOLOGY AND HEARING ASSOCIATES
Entity Type:Organization
Organization Name:AUDIOLOGY AND HEARING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:GIOVINAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:330-372-4500
Mailing Address - Street 1:8700 E MARKET ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2340
Mailing Address - Country:US
Mailing Address - Phone:330-372-4500
Mailing Address - Fax:330-372-4540
Practice Address - Street 1:8700 E MARKET ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2340
Practice Address - Country:US
Practice Address - Phone:330-372-4500
Practice Address - Fax:330-372-4540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA1063261QH0700X, 332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2188798Medicaid
OH2188798Medicaid
OHAU9350321Medicare PIN