Olivia Van Wagner, LLC

Primary specialty

AudiologistTaxonomy code 231H00000X

Legal business name

OLIVIA VAN WAGNER, LLC

Practice address

860 Lower Ferry Rd Ste 2
Ewing, NJ 08628-3516

Phone

(609) 245-0006

NPI assigned

Oct 25, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Olivia Van Wagner, MA

Title

Owner

Phone

(609) 245-0006

Specialties & licenses 2

Addresses

Other names 1

• Ewing Hearing Health Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520985600000",
    "number": "1801308259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 LOWER FERRY RD STE 2",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283516",
            "telephone_number": "609-245-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 LOWER FERRY RD STE 2",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283516",
            "telephone_number": "609-245-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVIA VAN WAGNER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-25",
        "last_updated": "2018-03-14",
        "status": "A",
        "authorized_official_last_name": "VAN WAGNER",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-245-0006",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "YA00255",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ewing Hearing Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Audiologist in Ewing, NJ
• Providers in Ewing, NJ by specialty
• Audiologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.