Provider Demographics
NPI:1265804439
Name:CRM AUDIOLOGY PC
Entity type:Organization
Organization Name:CRM AUDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSO-MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:914-997-1743
Mailing Address - Street 1:2975 WESTCHESTER AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PURCHASE
Mailing Address - State:NY
Mailing Address - Zip Code:10577-2518
Mailing Address - Country:US
Mailing Address - Phone:914-997-1743
Mailing Address - Fax:914-437-7306
Practice Address - Street 1:2975 WESTCHESTER AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:PURCHASE
Practice Address - State:NY
Practice Address - Zip Code:10577-2518
Practice Address - Country:US
Practice Address - Phone:914-997-1743
Practice Address - Fax:914-437-7306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-27
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002592-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty