Provider Demographics
NPI:1306083019
Name:PAT DAVID BIONDI MA-CCCA
Entity type:Organization
Organization Name:PAT DAVID BIONDI MA-CCCA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BIONDI
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:973-777-5335
Mailing Address - Street 1:1115 CLIFTON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3649
Mailing Address - Country:US
Mailing Address - Phone:973-777-5335
Mailing Address - Fax:973-777-3348
Practice Address - Street 1:1115 CLIFTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3649
Practice Address - Country:US
Practice Address - Phone:973-777-5335
Practice Address - Fax:973-777-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty