Basic Information
Provider Information
NPI: 1467606889
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EDDINS
FirstName: DAVID
MiddleName: A.
NamePrefix: DR.
NameSuffix:  
Credential: PH.D., M.S., CCC-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2365 S CLINTON AVE
Address2: SUITE 200
City: ROCHESTER
State: NY
PostalCode: 146182663
CountryCode: US
TelephoneNumber: 5857585700
FaxNumber: 5857581297
Practice Location
Address1: 2365 S CLINTON AVE
Address2: SUITE 200
City: ROCHESTER
State: NY
PostalCode: 146182663
CountryCode: US
TelephoneNumber: 5857585700
FaxNumber: 5857581297
Other Information
ProviderEnumerationDate: 11/12/2008
LastUpdateDate: 11/12/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237600000X001792-1NYY Speech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter 

No ID Information.


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