Provider Demographics
NPI:1548546807
Name:NORTH SHORE HEARING, P.C.
Entity type:Organization
Organization Name:NORTH SHORE HEARING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAULKNOR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC/A
Authorized Official - Phone:631-403-4885
Mailing Address - Street 1:45 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHOREHAM
Mailing Address - State:NY
Mailing Address - Zip Code:11786-2053
Mailing Address - Country:US
Mailing Address - Phone:631-764-3017
Mailing Address - Fax:631-425-4670
Practice Address - Street 1:45 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:SHOREHAM
Practice Address - State:NY
Practice Address - Zip Code:11786-2053
Practice Address - Country:US
Practice Address - Phone:631-764-3017
Practice Address - Fax:631-425-4670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00-1371237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty