Provider Demographics
NPI:1508258203
Name:HEARING CENTER AT ADVANCED ENT SPECIALISTS LLC
Entity Type:Organization
Organization Name:HEARING CENTER AT ADVANCED ENT SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PARAMESWARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-858-5885
Mailing Address - Street 1:44035 RIVERSIDE PKWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8260
Mailing Address - Country:US
Mailing Address - Phone:703-858-5885
Mailing Address - Fax:703-858-5001
Practice Address - Street 1:44035 RIVERSIDE PKWY
Practice Address - Street 2:SUITE 450
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8260
Practice Address - Country:US
Practice Address - Phone:703-858-5885
Practice Address - Fax:703-858-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232845332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment