Provider Demographics
NPI:1730425000
Name:ASSOCIATES IN AUDIOLOGY OF CHESTER COUNTY
Entity type:Organization
Organization Name:ASSOCIATES IN AUDIOLOGY OF CHESTER COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MCCANDLESS
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:610-363-1340
Mailing Address - Street 1:407 W LINCOLN HWY
Mailing Address - Street 2:STE 50
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2521
Mailing Address - Country:US
Mailing Address - Phone:610-363-1340
Mailing Address - Fax:
Practice Address - Street 1:407 W LINCOLN HWY
Practice Address - Street 2:STE 50
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2521
Practice Address - Country:US
Practice Address - Phone:610-363-1340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT006163231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBB968ZOtherMEDICARE ID