Provider Demographics
NPI:1124293287
Name:GEORGE LUDWIG, INC
Entity type:Organization
Organization Name:GEORGE LUDWIG, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LUDWIG
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-A
Authorized Official - Phone:607-729-8406
Mailing Address - Street 1:200 PLAZA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-3680
Mailing Address - Country:US
Mailing Address - Phone:607-729-8406
Mailing Address - Fax:
Practice Address - Street 1:200 PLAZA DR
Practice Address - Street 2:SUITE B
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-3680
Practice Address - Country:US
Practice Address - Phone:607-729-8406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001192-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA0842Medicare PIN
P31539Medicare UPIN