Provider Demographics
NPI:1629561279
Name:LONG ISLAND QUEEN HEARING ASSO INC
Entity Type:Organization
Organization Name:LONG ISLAND QUEEN HEARING ASSO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-623-3700
Mailing Address - Street 1:1953 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-2820
Mailing Address - Country:US
Mailing Address - Phone:516-623-3700
Mailing Address - Fax:631-499-3062
Practice Address - Street 1:1423 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3840
Practice Address - Country:US
Practice Address - Phone:855-423-3700
Practice Address - Fax:631-499-3062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000028517332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15000028517OtherNYS HEARING AID DISPENSER LICENSE