# BLOOMSBURG UNIVERSITY SPEECH & HEARING CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558446468
- **Authorized official:** DR. RICHARD M ANGELO PH.D. (DIRECTOR OF CLINICAL SERVICES)
- **Authorized official phone:** (570) 389-5380

## Contact information

- **Practice address:** 400 E 2ND ST, CENTENNIAL HALL, BLOOMSBURG, PA 17815-1301
- **Practice address phone:** (570) 389-5380
- **Practice address fax:** (570) 389-5022
- **Mailing address:** 400 E. 2ND STREET, CENTENNIAL HALL, BLOOMSBURG, PA 17815
- **Mailing address phone:** (570) 389-5380
- **Mailing address fax:** (570) 389-5022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 231H00000X | Audiologist | — | — | Yes |
| 231HA2400X | Assistive Technology Practitioner Audiologist | D00617 | PA | — |
| 231HA2500X | Assistive Technology Supplier Audiologist | D00617 | PA | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 237600000X | Audiologist-Hearing Aid Fitter | D00617 | PA | — |

## Other

- **Enumeration date:** 10/26/2006
- **Last updated:** 10/17/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0019428910002 | — | PA |
| 05 | — | 0019428910003 | — | PA |
| 01 | — | 50009520 | CAPITAL BLUE CROSS | PA |
| 01 | — | 50218 | GEISINGER HEALTH PLAN | PA |