Provider Demographics
NPI:1659426807
Name:NEW HEARING AID CENTER OF GREEN ACRES
Entity Type:Organization
Organization Name:NEW HEARING AID CENTER OF GREEN ACRES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CROHN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:516-791-8800
Mailing Address - Street 1:12 GREEN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1501
Mailing Address - Country:US
Mailing Address - Phone:516-791-8800
Mailing Address - Fax:516-791-1167
Practice Address - Street 1:12 GREEN ACRES RD
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1501
Practice Address - Country:US
Practice Address - Phone:516-791-8800
Practice Address - Fax:516-791-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000006315231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01297534Medicaid
NY000933652001OtherUNITED HEALTHCARE
NY=========001OtherHEALTH FIRST NY
NY=========001OtherCHILD HEALTH PLUS
NY000933652001OtherUNITED HEALTHCARE