Provider Demographics
NPI:1891352092
Name:LIVINGSTON AUDIOLOGY, PC
Entity Type:Organization
Organization Name:LIVINGSTON AUDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIVINGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:317-464-7082
Mailing Address - Street 1:11980 TAVERNIER DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-8192
Mailing Address - Country:US
Mailing Address - Phone:317-464-7082
Mailing Address - Fax:
Practice Address - Street 1:2825 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-1701
Practice Address - Country:US
Practice Address - Phone:765-447-0131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech