Organization
MODERN AUDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TAVENIERE AUD (OWNER)
(718) 813-8361
Entity
Organization
Contact information
Practice address
220 E 161ST ST, BRONX, NY 10451-3543
(718) 813-8361
Mailing address
666 W END AVE, NEW YORK, NY 10025-7461
(718) 813-8361
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548448798
NPI
NY
Enumeration date
02/10/2021
Last updated
02/10/2021
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