Provider Demographics
NPI:1811344104
Name:PHYSICIAN HEARING CENTERS
Entity type:Organization
Organization Name:PHYSICIAN HEARING CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEIZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-588-7266
Mailing Address - Street 1:115 ROUTE 46
Mailing Address - Street 2:BLDG G, 2ND FLOOR
Mailing Address - City:MOUNTAIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07046-1668
Mailing Address - Country:US
Mailing Address - Phone:973-588-7266
Mailing Address - Fax:973-588-7268
Practice Address - Street 1:6770 MAYFIELD RD
Practice Address - Street 2:SUITE 210
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-2299
Practice Address - Country:US
Practice Address - Phone:440-461-0766
Practice Address - Fax:440-461-8221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHHAD03032237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty