Provider Demographics
NPI:1386603843
Name:SOUTHERN TIER AUDIOLOGY ASSOCIATES PC
Entity type:Organization
Organization Name:SOUTHERN TIER AUDIOLOGY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GIOVANNINI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-A
Authorized Official - Phone:607-734-0494
Mailing Address - Street 1:301 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-2829
Mailing Address - Country:US
Mailing Address - Phone:607-734-0494
Mailing Address - Fax:607-734-0880
Practice Address - Street 1:301 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2829
Practice Address - Country:US
Practice Address - Phone:607-734-0494
Practice Address - Fax:607-734-0880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14000000850237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01214584Medicaid
NY7526OtherBC & BS OF CENTRAL NY
NY52379AMedicare ID - Type UnspecifiedMEDICARE
NY01214584Medicaid