Provider Demographics
NPI:1710051685
Name:CRM AUDIOLOGY, PC
Entity Type:Organization
Organization Name:CRM AUDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSO-MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:914-997-1743
Mailing Address - Street 1:2975 WESTCHESTER AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2500
Mailing Address - Country:US
Mailing Address - Phone:914-997-1743
Mailing Address - Fax:914-437-7306
Practice Address - Street 1:2975 WESTCHESTER AVE STE 202
Practice Address - Street 2:
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2500
Practice Address - Country:US
Practice Address - Phone:914-997-1743
Practice Address - Fax:914-437-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1815231H00000X
NY14000015622231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM70961Medicare ID - Type Unspecified
NYMAW161Medicare PIN