Organization
STATEN ISLAND AUDIOLOGICAL SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY E GOODACRE AUD, CCC-A (PRESIDENT)
(718) 981-6020
Entity
Organization
Contact information
Practice address
1173 FOREST AVE, STATEN ISLAND, NY 10310-2408
(718) 981-6020
(718) 876-8370
Mailing address
1173 FOREST AVE, STATEN ISLAND, NY 10310-2408
(718) 981-6020
(718) 876-8370
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
000603
NY
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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