Provider Demographics
NPI:1447628771
Name:ELMIRA HEARING AID CENTER
Entity type:Organization
Organization Name:ELMIRA HEARING AID CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCUE
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:6077-334-7830
Mailing Address - Street 1:1100 CLEMENS CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901
Mailing Address - Country:US
Mailing Address - Phone:607-733-4783
Mailing Address - Fax:607-733-6037
Practice Address - Street 1:1100 CLEMENS CENTER PKWY
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-1563
Practice Address - Country:US
Practice Address - Phone:607-733-4783
Practice Address - Fax:607-733-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000010112237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty