Provider Demographics
NPI:1386709855
Name:SUMMIT HEARING AID CENTER LLC
Entity type:Organization
Organization Name:SUMMIT HEARING AID CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:908-277-6886
Mailing Address - Street 1:75 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3614
Mailing Address - Country:US
Mailing Address - Phone:908-277-6886
Mailing Address - Fax:908-277-3478
Practice Address - Street 1:75 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3614
Practice Address - Country:US
Practice Address - Phone:908-277-6886
Practice Address - Fax:908-277-3478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYA00102237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0040689OtherAETNA
NJ81782OtherUNITED HEALTHCARE
NJF10048OtherHEALTH NET
NJ3177700Medicaid
NJUS026OtherOXFORD
NJ0031631Medicaid
NJ122363Medicare PIN