Provider Demographics
NPI:1598945966
Name:ADVANCED AUDIOLOGY SERVICES
Entity Type:Organization
Organization Name:ADVANCED AUDIOLOGY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MADHU
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-A
Authorized Official - Phone:330-666-0619
Mailing Address - Street 1:3577 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-8331
Mailing Address - Country:US
Mailing Address - Phone:330-666-0619
Mailing Address - Fax:
Practice Address - Street 1:3250 W MARKET ST
Practice Address - Street 2:SUITE # 4
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3336
Practice Address - Country:US
Practice Address - Phone:330-666-0619
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01023866231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty