Provider Demographics
NPI:1760768931
Name:THE FAMILY HEARING CENTER OF MARLTON,L.L.C.
Entity Type:Organization
Organization Name:THE FAMILY HEARING CENTER OF MARLTON,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ISIDORE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:732-818-3610
Mailing Address - Street 1:2001 LINCOLN DR W STE E
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1531
Mailing Address - Country:US
Mailing Address - Phone:856-596-9670
Mailing Address - Fax:
Practice Address - Street 1:2001 LINCOLN DR W STE E
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-1531
Practice Address - Country:US
Practice Address - Phone:856-596-9670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00032200231H00000X
NJ25MG00067800231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ115350DBJMedicare PIN