Provider Demographics
NPI:1669533691
Name:HEARING TECHNOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:HEARING TECHNOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:BRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:610-747-1100
Mailing Address - Street 1:143 BALA AVE
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-3317
Mailing Address - Country:US
Mailing Address - Phone:610-747-1100
Mailing Address - Fax:610-747-1118
Practice Address - Street 1:143 BALA AVE
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-3317
Practice Address - Country:US
Practice Address - Phone:610-747-1100
Practice Address - Fax:610-747-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000123L237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0844536000OtherINDIVIDUAL HMO ID
PA001481681OtherHIGHMARK BS ID
PA000223955OtherINDIVIDUAL HIGHMARK BS ID
PA2146958000OtherHMO ID
PA2146958000OtherHMO ID
PA084341Medicare ID - Type UnspecifiedMEDICARE ID