EASTSIDE AUDIOLOGY SERVICES, LLC (NPI# 1548570807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548570807 |
| Entity Type | Organization |
| Organization Name | EASTSIDE AUDIOLOGY SERVICES, LLC |
| Practice Address |
4000 Medical Center Dr Suite 404 Fayetteville NY 13066-6631 |
| Practice Telephone | 3154547315 |
| Practice Fax Number | 3156173694 |
| Mailing Telephone | 3154547315 |
| Mailing Fax Number | 3156173694 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |
| Authorized Official Name | DR. SUZANNE M. KATKO (CO-PRESIDENT) |
| Authorized Official Telephone | 3154547315 |
| Authorized Official Credential | AUD, CCC-A |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 231H00000X | Audiologist | 000093 | NY | Speech, Language and Hearing Service Providers |
| Y | 231H00000X | Audiologist | 001041 | NY | Speech, Language and Hearing Service Providers |
| Street Address |
4000 MEDICAL CENTER DR SUITE 404 |
| City | FAYETTEVILLE |
| State | NY |
| Zip Code | 13066-6631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154322519 | Gerard S Rodziewicz | Neurological Surgery | 4000 Medical Center Dr, Suite 108, Fayetteville, NY 13066-6631 | 2005-08-09 |
| 1144633702 | Tara Brackley | Optometrist | 4000 Medical Center Dr, Suite 207, Fayetteville, NY 13066-6631 | 2014-06-11 |
| 1992131973 | Adam W Paddock | Physician Assistant | 4000 Medical Center Dr, Fayetteville, NY 13066-6631 | 2013-09-23 |
| 1003035494 | Rui Wang | Acupuncturist | 4000 Medical Center Dr, Suite 209, Fayetteville, NY 13066-6631 | 2007-04-24 |
| 1619011715 | William Tucker Md Pllc | Ophthalmology | 4000 Medical Center Dr, Suite 207, Fayetteville, NY 13066-6631 | 2007-02-20 |
| 1689733974 | Cny Spine Medicine, Pllc | Physician Assistant | 4000 Medical Center Dr, Ste 4217, Fayetteville, NY 13066-6631 | 2006-12-06 |
| 1730273806 | William M Tucker | Ophthalmology | 4000 Medical Center Dr, Suite 207, Fayetteville, NY 13066-6631 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457819963 | Word Wellness Center, LLC | Psychologist | 6836 E Genesee Street, Suite A, Fayetteville, NY 13066 | 2019-03-05 |
| 1629529060 | Lorna Boyer Chase | Marriage & Family Therapist | 109 White Heron Circle, Fayetteville, NY 13066 | 2016-10-20 |
| 1699221432 | Roman Batyuk | Nurse Practitioner | 4100 Medical Center Drive, Fayetteville, NY 13066 | 2016-08-31 |
| 1427405133 | National Eye Care, Inc | Optometrist | 5160 Kinloch Circle, Fayetteville, NY 13066 | 2016-05-23 |
| 1013375328 | Kristin Kukenberger | Chiropractor | 7000 E Genesee St Bldg B, Fayetteville, NY 13066 | 2016-02-01 |
| 1124394671 | Susan Hartman Brenizer | Marriage & Family Therapist | 7000 E Genesee St Lyndon Office Park, Bldg. A, Second Floor (upper Level), Fayetteville, NY 13066 | 2012-03-29 |
| 1245541432 | Rene L Converse | Occupational Therapist | 7200 E. Genesee Street, Fayetteville, NY 13066 | 2010-06-23 |
| 1689815805 | Menorah Park Group Residents | Clinic/Center | 12 Jamar Drive, Dewitt, NY 13066 | 2009-03-18 |
| 1063677458 | John Marcena Glezen | Obstetrics & Gynecology | 1 The Gazebo, Fayetteville, NY 13066 | 2008-07-24 |
| 1629232418 | Tucker Martin Harris | Otolaryngology | 4000 Medical Center Dr # 117, Fayetteville, NY 13066 | 2008-07-11 |
| Find all providers in zip 13066 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114408226 | Tashia S Gadlin | Audiologist | 1179 N College Ave, Fayetteville, AR 72703-1955 | 2018-08-27 |
| 1841786506 | Rachel Garrette | Audiologist | 1260 Highway 54 W Ste 203, Fayetteville, GA 30214-4513 | 2018-07-06 |
| 1265950406 | Jordan Sgroi | Audiologist | 544 Towne Dr, Fayetteville, NY 13066-1331 | 2017-09-08 |
| 1881030732 | Dustin Matthew Richards | Audiologist | 2630 E Citizens Dr Ste 7, Fayetteville, AR 72703-4797 | 2013-05-20 |
| 1831465608 | Gn Hearing Care Corp | Audiologist | 4310 Medical Center Dr Ste 310, Fayetteville, NY 13066-6625 | 2012-03-27 |
| 1043523459 | Carolyn Hornberger Dunn | Audiologist | 1240 Highway 54 W Ste 710, Fayetteville, GA 30214-4565 | 2010-07-15 |
| 1043543788 | Byron Douglas Owens | Audiologist | 2508 Colgate Drive, Fayetteville, NC 28304-3709 | 2009-09-14 |
| 1619108982 | Iris Braswell Phillips | Audiologist | 7300 South Raeford Road, Fayetteville, NC 28304 | 2009-08-04 |
| 1346422284 | Tawnia Hope Smith | Audiologist | Cape Fear Valley Health System, 1638 Owen Dr., Fayetteville, NC 28302 | 2007-12-03 |
| 1972726578 | University of Arkansas | Audiologist | 606 N Razorback Rd, Fayetteville, AR 72701-3110 | 2007-04-11 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 13066 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.