Provider Demographics
NPI:1669729455
Name:BOOZ, SETH (HAD)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:BOOZ
Suffix:
Gender:M
Credentials:HAD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 E MAIN ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:NEW HOLLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17557-1407
Mailing Address - Country:US
Mailing Address - Phone:717-354-0743
Mailing Address - Fax:
Practice Address - Street 1:566 E MAIN ST
Practice Address - Street 2:SUITE D
Practice Address - City:NEW HOLLAND
Practice Address - State:PA
Practice Address - Zip Code:17557-1407
Practice Address - Country:US
Practice Address - Phone:717-354-0743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD00995332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment