Provider Demographics
NPI:1366990848
Name:GN AUDIOLOGY PLLC
Entity type:Organization
Organization Name:GN AUDIOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOSTAS
Authorized Official - Middle Name:
Authorized Official - Last Name:NEOCLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-261-9398
Mailing Address - Street 1:4117 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5605
Mailing Address - Country:US
Mailing Address - Phone:516-261-9398
Mailing Address - Fax:516-261-9399
Practice Address - Street 1:4770 SUNRISE HWY STE 106
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA PARK
Practice Address - State:NY
Practice Address - Zip Code:11762-2911
Practice Address - Country:US
Practice Address - Phone:516-261-9398
Practice Address - Fax:516-261-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY15000026480261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech