Provider Demographics
NPI:1710975149
Name:AURORA AUDIOLOGY & SPEECH ASSOCIATES, INC.
Entity Type:Organization
Organization Name:AURORA AUDIOLOGY & SPEECH ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:716-652-6464
Mailing Address - Street 1:97 HAMBURG ST
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-2139
Mailing Address - Country:US
Mailing Address - Phone:716-652-6464
Mailing Address - Fax:716-652-6499
Practice Address - Street 1:97 HAMBURG ST
Practice Address - Street 2:
Practice Address - City:EAST AURORA
Practice Address - State:NY
Practice Address - Zip Code:14052-2139
Practice Address - Country:US
Practice Address - Phone:716-652-6464
Practice Address - Fax:716-652-6499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000580026002OtherBLUECROSS BLUESHIELD/CB
NYAA0388Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER