Provider Demographics
NPI: | 1124316609 |
---|---|
Name: | LONG ISLAND QUEENS HEARING ASSO INC |
Entity type: | Organization |
Organization Name: | LONG ISLAND QUEENS HEARING ASSO INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | STEPHEN |
Authorized Official - Middle Name: | H |
Authorized Official - Last Name: | ASHINOFF |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OD |
Authorized Official - Phone: | 855-423-3700 |
Mailing Address - Street 1: | 1953 GRAND AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | NORTH BALDWIN |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11510-2820 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 855-423-3700 |
Mailing Address - Fax: | 631-499-3062 |
Practice Address - Street 1: | 360A W MERRICK RD |
Practice Address - Street 2: | |
Practice Address - City: | VALLEY STREAM |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11580-5354 |
Practice Address - Country: | US |
Practice Address - Phone: | 855-423-3700 |
Practice Address - Fax: | 631-499-3062 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-07-18 |
Last Update Date: | 2017-01-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 237700000X | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | Group - Single Specialty |