Provider Demographics
NPI:1114556545
Name:BYRNE, SEAN
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BYRNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:ARCHBALD
Mailing Address - State:PA
Mailing Address - Zip Code:18403-2006
Mailing Address - Country:US
Mailing Address - Phone:570-335-0355
Mailing Address - Fax:
Practice Address - Street 1:588 SUSQUEHANNA BLVD
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-3372
Practice Address - Country:US
Practice Address - Phone:570-751-5342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1265904908OtherMIRACLE EAR