Provider Demographics
NPI:1720100597
Name:ALLEN AUDIOLOGY & WESTGATE HEARING INC
Entity type:Organization
Organization Name:ALLEN AUDIOLOGY & WESTGATE HEARING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WIDDOWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-439-1196
Mailing Address - Street 1:401 N 17TH STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104
Mailing Address - Country:US
Mailing Address - Phone:610-439-1196
Mailing Address - Fax:610-434-2200
Practice Address - Street 1:401 N 17TH STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104
Practice Address - Country:US
Practice Address - Phone:610-439-1196
Practice Address - Fax:610-434-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
02654000OtherSENIOR BLUE
50022OtherAETNA
W1205998Medicare ID - Type Unspecified