Provider Demographics
NPI:1649569971
Name:ACE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:ACE AUDIOLOGY, LLC
Other - Org Name:ACE HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:CIONGOLI
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:570-784-8050
Mailing Address - Street 1:2201 5TH STREET HOLLOW RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-7757
Mailing Address - Country:US
Mailing Address - Phone:570-784-8050
Mailing Address - Fax:570-784-8058
Practice Address - Street 1:2201 5TH STREET HOLLOW RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-7757
Practice Address - Country:US
Practice Address - Phone:570-784-8050
Practice Address - Fax:570-784-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA190394RGQMedicare UPIN