Provider Demographics
NPI:1760199525
Name:AUDIOLOGY SERVICES OF WNY PLLC
Entity Type:Organization
Organization Name:AUDIOLOGY SERVICES OF WNY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-790-8480
Mailing Address - Street 1:610 WAYNE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2355
Mailing Address - Country:US
Mailing Address - Phone:716-790-8480
Mailing Address - Fax:716-790-8052
Practice Address - Street 1:610 WAYNE ST STE 2
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2355
Practice Address - Country:US
Practice Address - Phone:716-790-8480
Practice Address - Fax:716-790-8052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty