Basic Information
Provider Information | |||||||||
NPI: | 1992181374 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | RAMIREZ | ||||||||
FirstName: | NICHOLAS | ||||||||
MiddleName: | ERBY | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | AU.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 7574 N LA CHOLLA BLVD | ||||||||
Address2: |   | ||||||||
City: | TUCSON | ||||||||
State: | AZ | ||||||||
PostalCode: | 857412307 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5207422845 | ||||||||
FaxNumber: | 5207423881 | ||||||||
Practice Location | |||||||||
Address1: | 7574 N LA CHOLLA BLVD | ||||||||
Address2: |   | ||||||||
City: | TUCSON | ||||||||
State: | AZ | ||||||||
PostalCode: | 857412307 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5207422845 | ||||||||
FaxNumber: | 5207423881 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/07/2015 | ||||||||
LastUpdateDate: | 08/07/2015 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | DA9104 | AZ | Y |   | Speech, Language and Hearing Service Providers | Audiologist |   | 231HA2400X | DA9104 | AZ | N |   | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Practitioner | 237600000X | DA9104 | AZ | N |   | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |   |
No ID Information.