Provider Demographics
NPI:1093012940
Name:ENT PHYSICIANS AND SURGEONS, LLP
Entity Type:Organization
Organization Name:ENT PHYSICIANS AND SURGEONS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-693-7636
Mailing Address - Street 1:PO BOX 685
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-0685
Mailing Address - Country:US
Mailing Address - Phone:914-693-7636
Mailing Address - Fax:
Practice Address - Street 1:1055 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1045
Practice Address - Country:US
Practice Address - Phone:914-693-7636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Single Specialty