Provider Demographics
NPI:1528362357
Name:AUDIOLOGY SOLUTIONS, PLLC
Entity Type:Organization
Organization Name:AUDIOLOGY SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ANDRZEJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:716-474-7563
Mailing Address - Street 1:11500 WARNER GULF RD
Mailing Address - Street 2:
Mailing Address - City:EAST CONCORD
Mailing Address - State:NY
Mailing Address - Zip Code:14055-9705
Mailing Address - Country:US
Mailing Address - Phone:716-474-7563
Mailing Address - Fax:
Practice Address - Street 1:535 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1500
Practice Address - Country:US
Practice Address - Phone:716-474-7563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUDIOLOGY SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-09
Last Update Date:2011-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001168-1332S00000X
NY001168332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01111706Medicaid
NY01111706Medicaid