Provider Demographics
NPI:1417265448
Name:ALEXANDRIA AUDIOLOGY LLC
Entity Type:Organization
Organization Name:ALEXANDRIA AUDIOLOGY LLC
Other - Org Name:SONUS SF000201
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SISKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-823-3336
Mailing Address - Street 1:4660 KENMORE AVE
Mailing Address - Street 2:STE 409
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-1313
Mailing Address - Country:US
Mailing Address - Phone:703-823-3336
Mailing Address - Fax:703-823-4684
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-823-3336
Practice Address - Fax:703-823-4684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty