Provider Demographics
NPI:1629257647
Name:ANTHONY DURIG AUDIOLOGY INC.
Entity Type:Organization
Organization Name:ANTHONY DURIG AUDIOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:DURIG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:330-688-4115
Mailing Address - Street 1:3869 DARROW RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2691
Mailing Address - Country:US
Mailing Address - Phone:330-688-4115
Mailing Address - Fax:330-688-0316
Practice Address - Street 1:3869 DARROW RD
Practice Address - Street 2:SUITE 202
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2691
Practice Address - Country:US
Practice Address - Phone:330-688-4115
Practice Address - Fax:330-688-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA00523237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0609452Medicaid
OHAN9358931Medicare PIN