Provider Demographics
NPI:1053584029
Name:ALL EARS AUDIOLOGY OF ITHACA PLLC
Entity type:Organization
Organization Name:ALL EARS AUDIOLOGY OF ITHACA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:BASS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:607-257-3903
Mailing Address - Street 1:200 PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-2664
Mailing Address - Country:US
Mailing Address - Phone:607-257-3903
Mailing Address - Fax:607-266-8821
Practice Address - Street 1:200 PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-2664
Practice Address - Country:US
Practice Address - Phone:607-257-3903
Practice Address - Fax:607-266-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000450231H00000X
NY15000000623332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No332S00000XSuppliersHearing Aid EquipmentGroup - Multi-Specialty