Provider Demographics
NPI:1053587329
Name:CHENANGO AUDIOLOGY SERVICES PC
Entity type:Organization
Organization Name:CHENANGO AUDIOLOGY SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOROVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:AUDFAAA
Authorized Official - Phone:607-336-9003
Mailing Address - Street 1:26 CONKEY AVE BOX 127
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1756
Mailing Address - Country:US
Mailing Address - Phone:607-336-9903
Mailing Address - Fax:607-334-2578
Practice Address - Street 1:26 CONKEY AVE BOX 127
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1756
Practice Address - Country:US
Practice Address - Phone:607-336-9903
Practice Address - Fax:607-334-2578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01450848Medicaid
NY01450848Medicaid
NY54187BMedicare PIN