Provider Demographics
NPI:1053764845
Name:HEFFRON, CRAIG (AUD)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:
Last Name:HEFFRON
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 SILLS RD
Mailing Address - Street 2:BUILDING 10, SUITE A
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4869
Mailing Address - Country:US
Mailing Address - Phone:631-207-1119
Mailing Address - Fax:631-207-2293
Practice Address - Street 1:285 SILLS RD
Practice Address - Street 2:BUILDING 10, SUITE A
Practice Address - City:EAST PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4869
Practice Address - Country:US
Practice Address - Phone:631-207-1119
Practice Address - Fax:631-207-2293
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002670231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist