Provider Demographics
NPI:1588008056
Name:A.S.F. HEARING AID CENTERS, INC.
Entity Type:Organization
Organization Name:A.S.F. HEARING AID CENTERS, INC.
Other - Org Name:MIRACLE-EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD CERT. IN HEARING INSTRUMENT S
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:AVERSA
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:914-214-8190
Mailing Address - Street 1:1739 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1356
Mailing Address - Country:US
Mailing Address - Phone:914-214-8190
Mailing Address - Fax:914-603-3966
Practice Address - Street 1:1739 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547-1356
Practice Address - Country:US
Practice Address - Phone:914-214-8190
Practice Address - Fax:914-603-3966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000015490237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty