Active NPI
Audiology Balance Diagnostic P.C.
- Audiologist
- Brooklyn, NY
National Provider Identifier
1083940415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 002270
- Legal business name
- AUDIOLOGY BALANCE DIAGNOSTIC P.C.
- Practice address
- 50 Brighton 1St Rd
15L
Brooklyn, NY 11235 - Phone
- (732) 801-6984
- NPI assigned
- Oct 20, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Olesia Ivanutenko
- Title
- Au.D.
- Phone
- (732) 801-6984
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 002270 | NY | Primary |
Addresses
Primary practice location
50 Brighton 1St Rd
15L
Brooklyn, NY 11235
Mailing address
50 Brighton 1St Rd
15L
Brooklyn, NY 11235
National Provider Directory
National Provider DirectoryLocations
9920 4th Ave
Ste 206
Brooklyn, NY 11209
Phone (718) 238-8373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1255996800000",
"number": "1083940415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 BRIGHTON 1ST RD",
"address_2": "15L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 BRIGHTON 1ST RD",
"address_2": "15L",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11235",
"telephone_number": "732-801-6984"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AUDIOLOGY BALANCE DIAGNOSTIC P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2009-10-20",
"last_updated": "2009-10-20",
"status": "A",
"authorized_official_last_name": "IVANUTENKO",
"authorized_official_first_name": "OLESIA",
"authorized_official_title_or_position": "AU.D.",
"authorized_official_telephone_number": "732-801-6984",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Audiologist",
"state": "NY",
"license": "002270",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.