Provider Demographics
NPI:1295214963
Name:MODERN HEARING AIDS
Entity Type:Organization
Organization Name:MODERN HEARING AIDS
Other - Org Name:MODERN HEARING AIDS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:CIUCCIO-POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-836-7771
Mailing Address - Street 1:130 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:TUNKHANNOCK
Mailing Address - State:PA
Mailing Address - Zip Code:18657-1354
Mailing Address - Country:US
Mailing Address - Phone:570-836-7771
Mailing Address - Fax:570-836-1890
Practice Address - Street 1:130 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:TUNKHANNOCK
Practice Address - State:PA
Practice Address - Zip Code:18657-1354
Practice Address - Country:US
Practice Address - Phone:570-836-7771
Practice Address - Fax:570-836-1890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty