Provider Demographics
NPI:1194787895
Name:A HEARING HEALTHCARE CENTER INC.
Entity type:Organization
Organization Name:A HEARING HEALTHCARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF AUDIOLOGY
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:BLACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A, FAAA
Authorized Official - Phone:215-985-4964
Mailing Address - Street 1:1900 RITTENHOUSE SQ
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-5767
Mailing Address - Country:US
Mailing Address - Phone:215-985-4964
Mailing Address - Fax:215-985-1678
Practice Address - Street 1:1900 RITTENHOUSE SQ
Practice Address - Street 2:SUITE C-1
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-5767
Practice Address - Country:US
Practice Address - Phone:215-985-4964
Practice Address - Fax:215-985-1678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAD00159332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5222800Medicaid
BL289606Medicare ID - Type Unspecified
NJ5222800Medicaid