Provider Demographics
NPI:1609067214
Name:AUDIOLOGIC SOLUTIONS INC
Entity Type:Organization
Organization Name:AUDIOLOGIC SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALBORN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:518-283-6111
Mailing Address - Street 1:2 EMPIRE DR
Mailing Address - Street 2:SUITE 204
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-5730
Mailing Address - Country:US
Mailing Address - Phone:518-283-6111
Mailing Address - Fax:
Practice Address - Street 1:2 EMPIRE DR
Practice Address - Street 2:SUITE 204
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-5730
Practice Address - Country:US
Practice Address - Phone:518-283-6111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000000266332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS44296Medicare UPIN
NYBA0456Medicare PIN