Provider Demographics
NPI:1912491028
Name:CERTIFIED HEARING AID CARE
Entity Type:Organization
Organization Name:CERTIFIED HEARING AID CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NYS HEARING AID DISPENSER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:KONDELKA
Authorized Official - Last Name:CONTI
Authorized Official - Suffix:
Authorized Official - Credentials:NBC-HIS
Authorized Official - Phone:845-342-2227
Mailing Address - Street 1:399 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-3420
Mailing Address - Country:US
Mailing Address - Phone:845-342-2227
Mailing Address - Fax:845-342-2197
Practice Address - Street 1:399 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-3420
Practice Address - Country:US
Practice Address - Phone:845-342-2227
Practice Address - Fax:845-342-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000010089237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty