Provider Demographics
NPI:1346797891
Name:KLECKNER AUDIOLOGY LLC
Entity Type:Organization
Organization Name:KLECKNER AUDIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KLECKNER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:610-435-8299
Mailing Address - Street 1:3131 COLLEGE HEIGHTS BLVD STE 2600
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4878
Mailing Address - Country:US
Mailing Address - Phone:610-435-8299
Mailing Address - Fax:610-435-1940
Practice Address - Street 1:3131 COLLEGE HEIGHTS BLVD STE 2600
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4878
Practice Address - Country:US
Practice Address - Phone:610-435-8299
Practice Address - Fax:610-435-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty