Provider Demographics
NPI:1700293495
Name:STRONG MEMORIAL HOSPITAL AUDIOLOGY DEPARTMENT
Entity Type:Organization
Organization Name:STRONG MEMORIAL HOSPITAL AUDIOLOGY DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEERS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:585-758-5700
Mailing Address - Street 1:2365 CLINTON AVE S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2663
Mailing Address - Country:US
Mailing Address - Phone:585-758-5700
Mailing Address - Fax:585-758-1297
Practice Address - Street 1:2365 CLINTON AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2663
Practice Address - Country:US
Practice Address - Phone:585-758-5700
Practice Address - Fax:585-758-1297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002494261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1346285657Medicaid
NY1346285657Medicaid
NY1346285657Medicare NSC
NY1346285657Medicare PIN
NY1346285657Medicare UPIN