Provider Demographics
NPI:1366715047
Name:SZALC, KRISTA R (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTA
Middle Name:R
Last Name:SZALC
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-0685
Mailing Address - Country:US
Mailing Address - Phone:410-375-1013
Mailing Address - Fax:
Practice Address - Street 1:60 RED JACKET ST
Practice Address - Street 2:SUITE 16
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-1758
Practice Address - Country:US
Practice Address - Phone:585-335-5724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002202-1231H00000X
NY14000026425237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter