Provider Demographics
NPI:1619030699
Name:CENTRAL BUCKS HEARING CENTER, P. C.
Entity Type:Organization
Organization Name:CENTRAL BUCKS HEARING CENTER, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC A, FAAA
Authorized Official - Phone:215-345-4544
Mailing Address - Street 1:5033 SWAMP RD
Mailing Address - Street 2:SUITE 502
Mailing Address - City:FOUNTAINVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18923-9606
Mailing Address - Country:US
Mailing Address - Phone:215-345-4544
Mailing Address - Fax:215-345-9145
Practice Address - Street 1:5033 SWAMP RD
Practice Address - Street 2:SUITE 502
Practice Address - City:FOUNTAINVILLE
Practice Address - State:PA
Practice Address - Zip Code:18923-9606
Practice Address - Country:US
Practice Address - Phone:215-345-4544
Practice Address - Fax:215-345-9145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000563L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0538479000OtherAMERIHEALTH
PA0538479000OtherIBC HMO
PA0538479000OtherKEYSTONE
PA2081897OtherAETNA
PA388719OtherBLUE CROSS BLUE SHIELD
PA0538479000OtherIBC HMO