Provider Demographics
NPI:1245630839
Name:MID ISLAND AUDIOLOGY PLLC
Entity type:Organization
Organization Name:MID ISLAND AUDIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AUD
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:RECHER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:516-334-7000
Mailing Address - Street 1:3022 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-4320
Mailing Address - Country:US
Mailing Address - Phone:516-243-7445
Mailing Address - Fax:516-243-7445
Practice Address - Street 1:3022 MERRICK RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-4320
Practice Address - Country:US
Practice Address - Phone:516-243-7445
Practice Address - Fax:516-243-7445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-02
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002543-1231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Single Specialty