Provider Demographics
NPI:1598768582
Name:HOLLAR, SUSAN RUTH (AUD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:RUTH
Last Name:HOLLAR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MARYS AVE
Mailing Address - Street 2:DEPT OF AUDIOLOGY
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5848
Mailing Address - Country:US
Mailing Address - Phone:845-334-3121
Mailing Address - Fax:845-334-4789
Practice Address - Street 1:105 MARYS AVE
Practice Address - Street 2:DEPARTMENT OF AUDIOLOGY
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5848
Practice Address - Country:US
Practice Address - Phone:845-334-3121
Practice Address - Fax:845-334-4789
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000949231H00000X
NY140000021026237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter