Provider Demographics
NPI: | 1437130275 |
---|---|
Name: | KOVACS, JANE MARIE (MS) |
Entity type: | Individual |
Prefix: | MS |
First Name: | JANE |
Middle Name: | MARIE |
Last Name: | KOVACS |
Suffix: | |
Gender: | F |
Credentials: | MS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 213 1/2 W BROADWAY ST |
Mailing Address - Street 2: | |
Mailing Address - City: | MAUMEE |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43537-2102 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 419-241-6219 |
Mailing Address - Fax: | 419-241-5912 |
Practice Address - Street 1: | 3148 W CENTRAL AVE |
Practice Address - Street 2: | |
Practice Address - City: | TOLEDO |
Practice Address - State: | OH |
Practice Address - Zip Code: | 43606-2920 |
Practice Address - Country: | US |
Practice Address - Phone: | 419-241-6219 |
Practice Address - Fax: | 149-241-5912 |
Is Sole Proprietor?: | Not Answered |
Enumeration Date: | 2005-11-09 |
Last Update Date: | 2025-09-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
OH | A-01120 | 231H00000X, 237600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 237600000X | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | |
No | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | K00837081 | Medicare ID - Type Unspecified | |
OH | S45937 | Medicare UPIN |