Provider Demographics
NPI:1215983150
Name:ENHANCED HEARING SERVICES, LLC
Entity type:Organization
Organization Name:ENHANCED HEARING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:RENICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-763-3277
Mailing Address - Street 1:108 W PARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-3317
Mailing Address - Country:US
Mailing Address - Phone:516-736-3277
Mailing Address - Fax:516-431-7490
Practice Address - Street 1:108 W PARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-3317
Practice Address - Country:US
Practice Address - Phone:516-763-3277
Practice Address - Fax:516-431-7490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000024720237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYM2W891Medicare ID - Type Unspecified