Provider Demographics
NPI:1639843006
Name:KENSINGTON AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:KENSINGTON AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MADELEINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CISSNA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:301-221-2208
Mailing Address - Street 1:11014 GLUECK LN
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1618
Mailing Address - Country:US
Mailing Address - Phone:301-221-2208
Mailing Address - Fax:
Practice Address - Street 1:11014 GLUECK LN
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1618
Practice Address - Country:US
Practice Address - Phone:301-221-2208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty