Provider Demographics
NPI:1710602362
Name:RISE AUDIOLOGY, LLC
Entity Type:Organization
Organization Name:RISE AUDIOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENIFER
Authorized Official - Middle Name:WOO
Authorized Official - Last Name:CUSHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-846-0222
Mailing Address - Street 1:560 VAN REED RD STE 205
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1799
Mailing Address - Country:US
Mailing Address - Phone:610-750-6107
Mailing Address - Fax:
Practice Address - Street 1:560 VAN REED RD STE 205
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1799
Practice Address - Country:US
Practice Address - Phone:610-750-6107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty