Provider Demographics
NPI:1952657249
Name:GENESEE COUNTRY AUDIOLOGY SERVICES, P.C.
Entity Type:Organization
Organization Name:GENESEE COUNTRY AUDIOLOGY SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:KOZELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:585-787-0660
Mailing Address - Street 1:680 RIDGE ROAD
Mailing Address - Street 2:WEBSTER HEARING
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2353
Mailing Address - Country:US
Mailing Address - Phone:585-787-0660
Mailing Address - Fax:585-787-1385
Practice Address - Street 1:680 RIDGE ROAD
Practice Address - Street 2:WEBSTER HEARING
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2353
Practice Address - Country:US
Practice Address - Phone:585-787-0660
Practice Address - Fax:585-787-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty