Provider Demographics
NPI:1023593084
Name:EARVANNA
Entity type:Organization
Organization Name:EARVANNA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-385-7233
Mailing Address - Street 1:1605 N CEDAR CREST BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-820-7040
Mailing Address - Fax:610-820-7041
Practice Address - Street 1:1605 N CEDAR CREST BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2351
Practice Address - Country:US
Practice Address - Phone:610-820-7040
Practice Address - Fax:610-820-7041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA831933520Medicaid