Provider Demographics
NPI:1184943961
Name:QUALITY OF LIFE HEARING SOLUTIONS
Entity type:Organization
Organization Name:QUALITY OF LIFE HEARING SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOCHTERLE
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:845-238-5514
Mailing Address - Street 1:581 STATE ROUTE 17M
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3456
Mailing Address - Country:US
Mailing Address - Phone:845-238-5514
Mailing Address - Fax:845-238-5516
Practice Address - Street 1:96-05 QUEENS BLVD
Practice Address - Street 2:SEARS MIRACLE EAR
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-275-5954
Practice Address - Fax:718-275-5964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY15000018410OtherDEPARTMENT OF STATE DIVISION OF LICENSING SERVICES