Provider Demographics
NPI:1972869386
Name:GARDEN STATE HEARING
Entity Type:Organization
Organization Name:GARDEN STATE HEARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IZZY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-818-3611
Mailing Address - Street 1:75 LACEY RD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:WHITING
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-2938
Mailing Address - Country:US
Mailing Address - Phone:732-818-3611
Mailing Address - Fax:732-818-3663
Practice Address - Street 1:75 LACEY RD
Practice Address - Street 2:SUITE 1B
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2938
Practice Address - Country:US
Practice Address - Phone:732-818-3611
Practice Address - Fax:732-818-3663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech