Basic Information
| Provider Information | |||||||||
| NPI: | 1760768931 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THE FAMILY HEARING CENTER OF MARLTON,L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2001 LINCOLN DR W STE E | ||||||||
| Address2: | |||||||||
| City: | MARLTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080531531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565969670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 LINCOLN DR W STE E | ||||||||
| Address2: | |||||||||
| City: | MARLTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080531531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565969670 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2011 | ||||||||
| LastUpdateDate: | 06/20/2014 | ||||||||
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| AuthorizedOfficialLastName: | KIRSH | ||||||||
| AuthorizedOfficialFirstName: | ISIDORE | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7328183610 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231HA2400X | 25MG00067800 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Practitioner | 231H00000X | 41YA00032200 | NJ | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.