Provider Demographics
NPI:1457360281
Name:PERRY, LORRI ANN (AUD)
Entity type:Individual
Prefix:MRS
First Name:LORRI
Middle Name:ANN
Last Name:PERRY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 HURLEY AVE
Mailing Address - Street 2:KINGSTON AUDIOLOGY CENTER
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401
Mailing Address - Country:US
Mailing Address - Phone:845-331-9160
Mailing Address - Fax:845-331-2075
Practice Address - Street 1:211 HURLEY AVE
Practice Address - Street 2:KINGSTON AUDIOLOGY CENTER
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-331-9160
Practice Address - Fax:845-331-2075
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0015261231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7263231OtherAETNA US HEALTHCARE PPO
NY2587843OtherAETNA US HEALTHCARE HMO
NY000000052492OtherGHI HMO
NY10046112OtherCDPHP
NY7263231OtherAETNA US HEALTHCARE PPO