Provider Demographics
NPI:1568670412
Name:EAR CARE HEARING AID CENTER
Entity Type:Organization
Organization Name:EAR CARE HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BRECHEISEN
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING SPECIALIST
Authorized Official - Phone:845-567-2480
Mailing Address - Street 1:1229 ROUTE 300
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-567-2480
Mailing Address - Fax:845-567-2482
Practice Address - Street 1:1229 ROUTE 300
Practice Address - Street 2:SUITE 4
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-567-2480
Practice Address - Fax:845-567-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000012029332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02700250Medicaid