Provider Demographics
NPI:1356416150
Name:WATSON, ERNEST A (AAS, BH-HIS, ACA)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:A
Last Name:WATSON
Suffix:
Gender:M
Credentials:AAS, BH-HIS, ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALBANY AVE
Mailing Address - Street 2:SUITE G-8
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-2946
Mailing Address - Country:US
Mailing Address - Phone:845-338-3934
Mailing Address - Fax:845-338-3772
Practice Address - Street 1:1 ALBANY AVE
Practice Address - Street 2:SUITE G-8
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2946
Practice Address - Country:US
Practice Address - Phone:845-338-3934
Practice Address - Fax:845-338-3772
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000004764237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02653661Medicaid
NY443850OtherWELLCARE