Provider Demographics
NPI:1891360392
Name:OCEAN AUDIOLOGY INC
Entity Type:Organization
Organization Name:OCEAN AUDIOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-528-2690
Mailing Address - Street 1:26 JOURNAL SQ STE 306
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-4105
Mailing Address - Country:US
Mailing Address - Phone:201-721-5355
Mailing Address - Fax:201-721-5359
Practice Address - Street 1:26 JOURNAL SQ STE 306
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-4105
Practice Address - Country:US
Practice Address - Phone:201-721-5355
Practice Address - Fax:201-721-5359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0684244Medicaid