Provider Demographics
NPI:1134459258
Name:SANFORD HEIGHTS HEARING CENTER INC.
Entity Type:Organization
Organization Name:SANFORD HEIGHTS HEARING CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:N
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:973-275-1006
Mailing Address - Street 1:1984 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-3437
Mailing Address - Country:US
Mailing Address - Phone:973-275-1006
Mailing Address - Fax:973-275-1106
Practice Address - Street 1:1984 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-3437
Practice Address - Country:US
Practice Address - Phone:973-275-1006
Practice Address - Fax:973-275-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4501171OtherAETNA NON-HMO
NJ3909476000OtherAMERIHEALTH
NJ60015958OtherHORIZON NJ HEALTH
NJ1007016OtherAETNA HMO
NJ5352908Medicaid
NJ4501171OtherAETNA NON-HMO
NJ60015958OtherHORIZON NJ HEALTH
NJ=========OtherMAGNACARE
NJ1007016OtherAETNA HMO