Provider Demographics
NPI: | 1063671808 |
---|---|
Name: | PROGRESSIVE HEARING HEALTH, PA |
Entity type: | Organization |
Organization Name: | PROGRESSIVE HEARING HEALTH, PA |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | NEELESH |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | MEHENDALE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 972-731-7654 |
Mailing Address - Street 1: | 4401 COIT RD |
Mailing Address - Street 2: | SUITE 411 |
Mailing Address - City: | FRISCO |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75035-0500 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-731-7654 |
Mailing Address - Fax: | 972-731-6226 |
Practice Address - Street 1: | 4401 COIT RD |
Practice Address - Street 2: | SUITE 411 |
Practice Address - City: | FRISCO |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75035-0500 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-731-7654 |
Practice Address - Fax: | 972-731-6226 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-06-06 |
Last Update Date: | 2008-06-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 231HA2500X | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Supplier | Group - Single Specialty |