Basic Information
Provider Information
NPI: 1255752390
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMMOND
FirstName: MICHAEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: AUD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 70-01 BROADWAY
Address2: ELMHURST HOSPITAL - H BLDG 2ND FL- H2-82;HEARING AND SP
City: ELMHURST
State: NY
PostalCode: 11373
CountryCode: US
TelephoneNumber: 7183343394
FaxNumber: 7183343909
Practice Location
Address1: 70-01 BROADWAY
Address2: ELMHURST HOSPITAL - H BLDG 2ND FL- H2-82;HEARING AND SP
City: ELMHURST
State: NY
PostalCode: 11373
CountryCode: US
TelephoneNumber: 7183343394
FaxNumber: 7183343909
Other Information
ProviderEnumerationDate: 12/16/2013
LastUpdateDate: 12/16/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X002454NYY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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