Provider Demographics
NPI:1083743835
Name:CAMBRIDGE OTOLARYNGOLOGY
Entity Type:Organization
Organization Name:CAMBRIDGE OTOLARYNGOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-354-1010
Mailing Address - Street 1:300 MOUNT AUBURN ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5600
Mailing Address - Country:US
Mailing Address - Phone:617-354-1010
Mailing Address - Fax:617-354-7961
Practice Address - Street 1:300 MOUNT AUBURN ST
Practice Address - Street 2:SUITE 308
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5600
Practice Address - Country:US
Practice Address - Phone:617-354-1010
Practice Address - Fax:617-354-7961
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAMBRIDGE OTOLARYNGOLOGY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-05
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty