Provider Demographics
NPI:1669506408
Name:ISLAND BETTER HEARING & OPTICAL INC
Entity type:Organization
Organization Name:ISLAND BETTER HEARING & OPTICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:TRENTACOSTE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:631-271-1018
Mailing Address - Street 1:1 SCHWAB RD STE 3
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1130
Mailing Address - Country:US
Mailing Address - Phone:631-271-1018
Mailing Address - Fax:
Practice Address - Street 1:1 SCHWAB RD STE 3
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1130
Practice Address - Country:US
Practice Address - Phone:631-271-1018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
237600000X
NY001009231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01760250Medicaid