Provider Demographics
NPI:1871634105
Name:PROFESSIONAL HEARING AID SERVICES INC
Entity Type:Organization
Organization Name:PROFESSIONAL HEARING AID SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-595-6313
Mailing Address - Street 1:45 ANDERSON DRIVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470
Mailing Address - Country:US
Mailing Address - Phone:973-595-6313
Mailing Address - Fax:
Practice Address - Street 1:45 ANDERSON DRIVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470
Practice Address - Country:US
Practice Address - Phone:973-595-6313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3224309Medicaid
208258Medicare ID - Type Unspecified