Provider Demographics
NPI:1871930503
Name:JOSEPH ANTHONY MOLINARO
Entity type:Organization
Organization Name:JOSEPH ANTHONY MOLINARO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MOLINARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-600-3245
Mailing Address - Street 1:2680 SNELLING AVE N
Mailing Address - Street 2:#265
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1876
Mailing Address - Country:US
Mailing Address - Phone:651-600-3245
Mailing Address - Fax:651-600-3182
Practice Address - Street 1:2680 SNELLING AVE N
Practice Address - Street 2:#265
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1876
Practice Address - Country:US
Practice Address - Phone:651-600-3245
Practice Address - Fax:651-600-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty