Provider Demographics
NPI:1295461432
Name:HEAR TO GO MOBILE HEARING CARE LLC
Entity type:Organization
Organization Name:HEAR TO GO MOBILE HEARING CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:315-641-4240
Mailing Address - Street 1:204 RIVERDALE RD
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-2810
Mailing Address - Country:US
Mailing Address - Phone:315-641-4240
Mailing Address - Fax:315-201-8818
Practice Address - Street 1:23 CANALVIEW MALL
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069-1734
Practice Address - Country:US
Practice Address - Phone:315-641-4240
Practice Address - Fax:315-201-8818
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEAR TO GO MOBILE HEARING CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-29
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY14000011616OtherHEARING AID DISPENSER REGISTRATION
NY001460-1OtherNYS AUDIOLOGIST LICENSE