Provider Demographics
NPI:1942581608
Name:JACKSON HEARING AIDS, LLC
Entity type:Organization
Organization Name:JACKSON HEARING AIDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:LONG
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:732-987-4218
Mailing Address - Street 1:27 N BAKER DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-3962
Mailing Address - Country:US
Mailing Address - Phone:732-987-4218
Mailing Address - Fax:732-987-4219
Practice Address - Street 1:177 FRANKLIN CORNER RD
Practice Address - Street 2:SUITE 1-B
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2548
Practice Address - Country:US
Practice Address - Phone:609-895-1666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JACKSON HEARING AIDS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00077300332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1154631323OtherNPI