Individual
MRS. MARIA THERESA MIDDLEBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCCA NY STATE LIC
Contact information
Practice address
624 BLACK RIVER BLVD, ROME, NY 13440-4326
(315) 336-7250
(315) 336-7254
Mailing address
624 BLACK RIVER BLVD, ROME, NY 13440-4326
(315) 336-7250
(315) 336-7254
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
000784
NY
231HA2500X
Assistive Technology Supplier Audiologist
Primary
14000005549
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01140050
—
NY
Enumeration date
02/09/2007
Last updated
03/20/2023
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