Provider Demographics
NPI:1114297975
Name:AUDIOLOGY SERVICES
Entity Type:Organization
Organization Name:AUDIOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAKIMETZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:212-644-1554
Mailing Address - Street 1:235 E 57TH ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2842
Mailing Address - Country:US
Mailing Address - Phone:212-644-1445
Mailing Address - Fax:212-644-6532
Practice Address - Street 1:235 E 57TH ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2842
Practice Address - Country:US
Practice Address - Phone:212-644-1445
Practice Address - Fax:212-644-6532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00418261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM01271Medicare UPIN