Provider Demographics
NPI:1982190195
Name:ARRA, NICKLAUS (AUD)
Entity Type:Individual
Prefix:
First Name:NICKLAUS
Middle Name:
Last Name:ARRA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2219
Mailing Address - Country:US
Mailing Address - Phone:215-590-7609
Mailing Address - Fax:
Practice Address - Street 1:500 W BUTLER AVE
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2219
Practice Address - Country:US
Practice Address - Phone:215-590-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2019-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006563237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter