Provider Demographics
NPI:1346770112
Name:NARDELLI AUDIOLOGY LLC
Entity Type:Organization
Organization Name:NARDELLI AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:CARNES
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:304-842-9428
Mailing Address - Street 1:111 STEELE ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1068
Mailing Address - Country:US
Mailing Address - Phone:304-842-9428
Mailing Address - Fax:304-842-6775
Practice Address - Street 1:111 STEELE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1068
Practice Address - Country:US
Practice Address - Phone:304-842-9428
Practice Address - Fax:304-842-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA-0248231H00000X
WVA0248237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty