Provider Demographics
NPI:1437130275
Name:KOVACS, JANE MARIE (MS)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:MARIE
Last Name:KOVACS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 1/2 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-2102
Mailing Address - Country:US
Mailing Address - Phone:419-241-6219
Mailing Address - Fax:419-241-5912
Practice Address - Street 1:3148 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-2920
Practice Address - Country:US
Practice Address - Phone:419-241-6219
Practice Address - Fax:149-241-5912
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-01120231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHK00837081Medicare ID - Type Unspecified
OHS45937Medicare UPIN