Provider Demographics
NPI:1922305549
Name:OCEAN COUNTY AUDIOLOGY CENTER INC
Entity Type:Organization
Organization Name:OCEAN COUNTY AUDIOLOGY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ENOCK
Authorized Official - Suffix:
Authorized Official - Credentials:SCD
Authorized Official - Phone:215-817-5697
Mailing Address - Street 1:74 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1995
Mailing Address - Country:US
Mailing Address - Phone:215-817-5697
Mailing Address - Fax:
Practice Address - Street 1:74 E 9TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1995
Practice Address - Country:US
Practice Address - Phone:215-817-5697
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00121500237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty