Basic Information
| Provider Information | |||||||||
| NPI: | 1396320388 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPECIALTY AUDIOLOGY ASSOCIATES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3445 HIGH POINT BLVD STE 400 | ||||||||
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| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180177817 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108665555 | ||||||||
| FaxNumber: | 6108663151 | ||||||||
| Practice Location | |||||||||
| Address1: | 903 CHESTNUT ST | ||||||||
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| City: | EMMAUS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180492021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109651093 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2021 | ||||||||
| LastUpdateDate: | 03/11/2021 | ||||||||
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| AuthorizedOfficialLastName: | DALLAS | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6108665555 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT MBA | ||||||||
| NPICertificationDate: | 03/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355A2700X | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Specialist/Technologist | Audiology Assistant |
No ID Information.