Provider Demographics
NPI:1649470923
Name:ALBRECHT AUDIOLOGY, LLC
Entity type:Organization
Organization Name:ALBRECHT AUDIOLOGY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BODDORF
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:814-867-4327
Mailing Address - Street 1:233 EASTERLY PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-6300
Mailing Address - Country:US
Mailing Address - Phone:814-867-4327
Mailing Address - Fax:814-867-3918
Practice Address - Street 1:233 EASTERLY PKWY
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-6300
Practice Address - Country:US
Practice Address - Phone:814-867-4327
Practice Address - Fax:814-867-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000391L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02653300OtherCAPITAL BLUE CROSS