Provider Demographics
NPI:1255005245
Name:RISE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:RISE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:WOO
Authorized Official - Last Name:CUSHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-846-0222
Mailing Address - Street 1:100 W MAIN ST STE 105
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-2023
Mailing Address - Country:US
Mailing Address - Phone:215-855-4217
Mailing Address - Fax:215-855-2240
Practice Address - Street 1:100 W MAIN ST STE 105
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-2023
Practice Address - Country:US
Practice Address - Phone:215-855-4217
Practice Address - Fax:215-855-2240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty