Provider Demographics
NPI:1578437075
Name:FORTELL RESEARCH INC.
Entity type:Organization
Organization Name:FORTELL RESEARCH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:917-382-4354
Mailing Address - Street 1:379 W BROADWAY OFC 549
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-5121
Mailing Address - Country:US
Mailing Address - Phone:917-382-4354
Mailing Address - Fax:
Practice Address - Street 1:530 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8015
Practice Address - Country:US
Practice Address - Phone:917-382-4354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty