Provider Demographics
NPI:1245635580
Name:ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC
Entity type:Organization
Organization Name:ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:POUYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:347-815-4327
Mailing Address - Street 1:461 PARK AVE S
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1902
Mailing Address - Country:US
Mailing Address - Phone:347-815-4327
Mailing Address - Fax:212-679-6472
Practice Address - Street 1:461 PARK AVE 5TH FLOOR
Practice Address - Street 2:ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1902
Practice Address - Country:US
Practice Address - Phone:347-815-4327
Practice Address - Fax:212-679-6472
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED AUDIOLOGY SERVICES OF NEW YORK, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237600000X
NY237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty