Provider Demographics
NPI:1275989121
Name:MILL NECK SERVICES CENTER FOR HEARING HEALTH LLC
Entity Type:Organization
Organization Name:MILL NECK SERVICES CENTER FOR HEARING HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REP
Authorized Official - Prefix:
Authorized Official - First Name:LORRETTA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-628-4268
Mailing Address - Street 1:40 FROST MILL RD
Mailing Address - Street 2:
Mailing Address - City:MILL NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11765-1102
Mailing Address - Country:US
Mailing Address - Phone:516-628-4268
Mailing Address - Fax:516-922-3889
Practice Address - Street 1:40 FROST MILL RD
Practice Address - Street 2:
Practice Address - City:MILL NECK
Practice Address - State:NY
Practice Address - Zip Code:11765-1102
Practice Address - Country:US
Practice Address - Phone:516-628-4268
Practice Address - Fax:516-922-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231H00000X, 237600000X, 237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100150881Medicare PIN