Provider Demographics
NPI:1720424146
Name:AUDIOLOGY CENTER OF MARYLAND INC
Entity type:Organization
Organization Name:AUDIOLOGY CENTER OF MARYLAND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ESMAELI
Authorized Official - Suffix:
Authorized Official - Credentials:SCD, CCC-A
Authorized Official - Phone:201-247-6608
Mailing Address - Street 1:11808 ETON MANOR DR
Mailing Address - Street 2:#202
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-3934
Mailing Address - Country:US
Mailing Address - Phone:201-247-6608
Mailing Address - Fax:
Practice Address - Street 1:11808 ETON MANOR DR
Practice Address - Street 2:#202
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876-3934
Practice Address - Country:US
Practice Address - Phone:201-247-6608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty