Provider Demographics
NPI:1871701870
Name:LOUIS R SIEMINSKI
Entity type:Organization
Organization Name:LOUIS R SIEMINSKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERAUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:SIEMINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:570-287-8649
Mailing Address - Street 1:601 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-3701
Mailing Address - Country:US
Mailing Address - Phone:570-287-8649
Mailing Address - Fax:570-287-9560
Practice Address - Street 1:601 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-3701
Practice Address - Country:US
Practice Address - Phone:570-287-8649
Practice Address - Fax:570-287-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000230L231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007785600004Medicaid
PA281757Medicare ID - Type Unspecified
PA1007785600004Medicaid