Eileen O'Sullivan
Individual provider Active NPI Audiologist · Wayne, NJ
NPI 1124061841 · NPPES record last updated Sep 6, 2011
Key facts
- NPI
- 1124061841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- YA000507 (NJ)
- Practice address
- 1211 Hamburg Tpke
Suite 205
Wayne, NJ 07470-5043 - Phone
- (973) 633-0808
- NPI assigned
- Jun 13, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| YA000507 | NJ | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ENT and Allergy Associates LLP | Past | Accepting new patients |
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | YA000507 | NJ | Yes |
Addresses
Primary practice location
1211 Hamburg Tpke
Suite 205
Wayne, NJ 07470-5043
Mailing address
1211 Hamburg Tpke
Suite 205
Wayne, NJ 07470-5043
Phone (973) 633-0808
Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.