| Organization Name: | WISE HEARING NEW JERSEY LLC |
| NPI Number: | 1184969115 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUBEN DARIO HENRIQUEZ (AUDIOPROSTHOLOGIST) |
| Mailing Address: | 7418 Bergenline Ave North Bergen |
| State: | NJ US |
| Postal Code: | 070475449 |
| Phone Number: | 2016248062 |
| Fax Number: | 2016248063 |
| NPI Enumeration Date: | 12/03/2012 |
| NPI Last Update Date: | 12/03/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | 25MG00075800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |