Provider Demographics
NPI:1164698106
Name:HEAR HERE
Entity Type:Organization
Organization Name:HEAR HERE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:607-369-3802
Mailing Address - Street 1:PO BOX C
Mailing Address - Street 2:194 MAIN ST.
Mailing Address - City:UNADILLA
Mailing Address - State:NY
Mailing Address - Zip Code:13849-0703
Mailing Address - Country:US
Mailing Address - Phone:607-369-3802
Mailing Address - Fax:607-369-5802
Practice Address - Street 1:194 MAIN ST
Practice Address - Street 2:
Practice Address - City:UNADILLA
Practice Address - State:NY
Practice Address - Zip Code:13849-0703
Practice Address - Country:US
Practice Address - Phone:607-369-3802
Practice Address - Fax:607-369-5802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001276-1231H00000X
NY15000000167237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56617AMedicare PIN