Provider Demographics
NPI:1164598496
Name:MATHIEU AUDIOLOGY SERVICES PC
Entity Type:Organization
Organization Name:MATHIEU AUDIOLOGY SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHAEFFLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:607-734-3329
Mailing Address - Street 1:170 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:14903-1318
Mailing Address - Country:US
Mailing Address - Phone:607-734-3329
Mailing Address - Fax:
Practice Address - Street 1:170 E 14TH ST
Practice Address - Street 2:
Practice Address - City:ELMIRA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:14903-1318
Practice Address - Country:US
Practice Address - Phone:607-734-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000208-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP98312-1Medicare UPIN