Basic Information
| Provider Information | |||||||||
| NPI: | 1871688622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BABIAN | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU.D.,CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2365 S CLINTON AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146182663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857585700 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2365 S CLINTON AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146182663 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857585700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/14/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | 0021581 | NY | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237600000X | 14000024787 | NY | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
ID Information
| ID | Type | State | Issuer | Description | 160743209 | 05 | NY | MEDICAID |