Provider Demographics
NPI:1629455951
Name:AUDIOLOGY ASSOCIATES OF LAS VEGAS
Entity Type:Organization
Organization Name:AUDIOLOGY ASSOCIATES OF LAS VEGAS
Other - Org Name:HEARING DYNAMICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF MANAGED CARE
Authorized Official - Prefix:
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-564-7115
Mailing Address - Street 1:2501 COTTONTAIL LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5125
Mailing Address - Country:US
Mailing Address - Phone:559-224-1344
Mailing Address - Fax:
Practice Address - Street 1:420 BULLARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1054
Practice Address - Country:US
Practice Address - Phone:559-224-1344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech