Provider Demographics
NPI:1134414402
Name:ADVANCED CARE AUDIOLOGY P.C.
Entity type:Organization
Organization Name:ADVANCED CARE AUDIOLOGY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-980-7700
Mailing Address - Street 1:88 NEW DORP PLZ S
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2902
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:88 NEW DORP PLZ S
Practice Address - Street 2:SUITE 105
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2902
Practice Address - Country:US
Practice Address - Phone:718-980-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002193-1231H00000X
NY002915-1332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332S00000XSuppliersHearing Aid Equipment
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty