NPI 1083665798 · live from the CMS NPI Registry
Kevin Kristalovich, AuD, CCC-A
Audiologist in Goodyear, AZ. National Provider Identifier 1083665798, active.
NPI record
| NPI | 1083665798 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 2700 N 140th Ave, Ste 107, Goodyear, AZ 85395 |
| Practice phone | 623-535-8770 |
| Mailing address | Po Box 12550, Belfast, ME 04915 |
| Enumerated | May 15, 2006 |
| Last updated | November 13, 2013 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | DA2024 (AZ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.