Provider Demographics
NPI:1336106624
Name:HRUTKAY, HEATHER M (AUD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:HRUTKAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:M
Other - Last Name:GASPAROVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:942 ROYAL CT
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-5042
Mailing Address - Country:US
Mailing Address - Phone:724-344-3014
Mailing Address - Fax:724-663-5360
Practice Address - Street 1:942 ROYAL CT
Practice Address - Street 2:
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-5042
Practice Address - Country:US
Practice Address - Phone:724-344-3014
Practice Address - Fax:724-663-5360
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001016L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PANECP04646OtherAUDIOLOGY AND HEARING AID
PANECP04646OtherAUDIOLOGY AND HEARING AID