Provider Demographics
NPI:1427349604
Name:PCL HEARING SERVICES/ISLIP
Entity type:Organization
Organization Name:PCL HEARING SERVICES/ISLIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LORING
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:631-348-0050
Mailing Address - Street 1:2950 EXPRESSWAY DR S
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-1400
Mailing Address - Country:US
Mailing Address - Phone:631-348-0050
Mailing Address - Fax:631-348-0105
Practice Address - Street 1:2950 EXPRESSWAY DR S
Practice Address - Street 2:SUITE 102
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-1400
Practice Address - Country:US
Practice Address - Phone:631-348-0050
Practice Address - Fax:631-348-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001725237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMAW501Medicare UPIN