Provider Demographics
NPI:1417472937
Name:HEARING SOLUTIONS OF NNY, LLC
Entity Type:Organization
Organization Name:HEARING SOLUTIONS OF NNY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMAR
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:315-755-1951
Mailing Address - Street 1:1104 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4353
Mailing Address - Country:US
Mailing Address - Phone:315-755-1941
Mailing Address - Fax:315-755-1954
Practice Address - Street 1:1104 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4353
Practice Address - Country:US
Practice Address - Phone:315-755-1941
Practice Address - Fax:315-755-1954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000040513261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04730530Medicaid