Provider Demographics
NPI:1154470417
Name:MESSINEO, MARC JOSEPH (AUD DOCTOR OF AUDIOL)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:JOSEPH
Last Name:MESSINEO
Suffix:
Gender:M
Credentials:AUD DOCTOR OF AUDIOL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6041 TRANSIT RD.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-691-3817
Mailing Address - Fax:716-691-3548
Practice Address - Street 1:6041 TRANSIT RD.
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051
Practice Address - Country:US
Practice Address - Phone:716-691-3817
Practice Address - Fax:716-691-3548
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001157231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9211446OtherINDEPENDENT HEALTH
NY005760672OtherBLUE CROSS BLUE SHIELD
NY00025858301OtherUNIVERA