Provider Demographics
NPI:1659892396
Name:NORTHEAST HEARING SOLUTIONS, INC
Entity Type:Organization
Organization Name:NORTHEAST HEARING SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BALLIET
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:570-459-1400
Mailing Address - Street 1:426 AIRPORT RD STE 139
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-3361
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:426 AIRPORT RD STE 139
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-3361
Practice Address - Country:US
Practice Address - Phone:570-459-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD01228237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty