Basic Information
| Provider Information | |||||||||
| NPI: | 1114970449 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OOTSCAN AUDIOLOGY, PSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | AVE ROOSEVELT | ||||||||
| Address2: | TORRE PLAZA LAS AMERICAS SUITE 402 CUARTO PISO | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009172710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877566560 | ||||||||
| FaxNumber: | 7877567456 | ||||||||
| Practice Location | |||||||||
| Address1: | AVE ROOSEVELT | ||||||||
| Address2: | TORRE PLAZA LAS AMERICAS SUITE 402 CUARTO PISO | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009172710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877566560 | ||||||||
| FaxNumber: | 7877567456 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 06/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | KOLODZIEJ | ||||||||
| AuthorizedOfficialFirstName: | ELAINE | ||||||||
| AuthorizedOfficialMiddleName: | FRANCES | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT-AUDIOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 7877566560 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | AUD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | 505 | PR | Y | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No ID Information.