Provider Demographics
NPI:1679511083
Name:EAST RIDGE HEARING & SPEECH CENTER, INC
Entity Type:Organization
Organization Name:EAST RIDGE HEARING & SPEECH CENTER, INC
Other - Org Name:HART HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:585-266-4130
Mailing Address - Street 1:468 TITUS AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-3541
Mailing Address - Country:US
Mailing Address - Phone:585-266-4130
Mailing Address - Fax:585-266-4532
Practice Address - Street 1:468 TITUS AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-3541
Practice Address - Country:US
Practice Address - Phone:585-266-4130
Practice Address - Fax:585-266-4532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY12181AMedicare ID - Type UnspecifiedGROUP ID