Provider Demographics
NPI:1922349554
Name:DJ HEARING ENTERPRISES, LLC
Entity Type:Organization
Organization Name:DJ HEARING ENTERPRISES, LLC
Other - Org Name:MIRACLE EAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRY
Authorized Official - Suffix:
Authorized Official - Credentials:NBC-HIS, ACA
Authorized Official - Phone:908-370-4413
Mailing Address - Street 1:117 W FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5017
Mailing Address - Country:US
Mailing Address - Phone:908-370-4413
Mailing Address - Fax:888-831-2486
Practice Address - Street 1:740 SOMERSET ST
Practice Address - Street 2:MIRACLE-EAR HEARING CENTER
Practice Address - City:WATCHUNG
Practice Address - State:NJ
Practice Address - Zip Code:07069-4941
Practice Address - Country:US
Practice Address - Phone:908-561-1247
Practice Address - Fax:908-561-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty