Basic Information
| Provider Information | |||||||||
| NPI: | 1053340729 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A & A MARYLAND HEARING CENTER, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 19110 MONTGOMERY VILLAGE AVE | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | GAITHERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208863702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019776317 | ||||||||
| FaxNumber: | 3019778504 | ||||||||
| Practice Location | |||||||||
| Address1: | 19110 MONTGOMERY VILLAGE AVE | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | GAITHERSBURG | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208863702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019776317 | ||||||||
| FaxNumber: | 3019778504 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SORENSEN | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3019776317 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | AU.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 00392 | MD | Y | 193400000X SINGLE SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 64003264 | 01 | MD | MEDICARE RAILROAD | OTHER | 801591 | 01 | MD | JOHN HOPKINS HEALTH | OTHER | 3460132 | 01 | MD | AETNA HMO | OTHER | LO98SW | 01 | MD | CAREFIRST MARYLAND XW,XIP | OTHER | 1320 | 01 | MD | CAREFIRST FEDERAL EMPLOYE | OTHER | 8608484 | 01 | MD | CIGNA | OTHER | 5309254 | 01 | MD | AETNA PPO | OTHER | 9419833 | 01 | MD | PHCS | OTHER | 221808 | 01 | MD | UNITED HEALTH CARE | OTHER |