Provider Demographics
NPI:1770742637
Name:PY, JEFFREY ANDREW (AUD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ANDREW
Last Name:PY
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 RANDOLPH RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28207-2034
Mailing Address - Country:US
Mailing Address - Phone:704-290-9696
Mailing Address - Fax:704-332-3261
Practice Address - Street 1:2711 RANDOLPH RD
Practice Address - Street 2:SUITE 307
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2034
Practice Address - Country:US
Practice Address - Phone:704-290-9696
Practice Address - Fax:704-332-3261
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2016-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1462231H00000X
NC10322231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ43087AOtherMEDICARE
NC177XMOtherBCBSNC
9227990OtherAETNA
9461561OtherCIGNA
SC30448184OtherSELECT HEALTH
SCSAN105Medicaid