Provider Demographics
NPI:1518093533
Name:AUDIOLOGY INC
Entity Type:Organization
Organization Name:AUDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAGARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:304-267-8220
Mailing Address - Street 1:400 W KING ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-3204
Mailing Address - Country:US
Mailing Address - Phone:304-267-8220
Mailing Address - Fax:304-267-4292
Practice Address - Street 1:400 W KING ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3204
Practice Address - Country:US
Practice Address - Phone:304-267-8220
Practice Address - Fax:304-267-4292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVA0025231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVW40145Medicare UPIN
WVAUSP01151Medicare ID - Type Unspecified