Provider Demographics
NPI:1174631733
Name:CARLISLE EAR NOSE & THROAT ASSOCIATES
Entity Type:Organization
Organization Name:CARLISLE EAR NOSE & THROAT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:FERRARO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-243-0616
Mailing Address - Street 1:9 BROOKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17015-9126
Mailing Address - Country:US
Mailing Address - Phone:717-243-0616
Mailing Address - Fax:717-245-2351
Practice Address - Street 1:9 BROOKWOOD AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17015-9126
Practice Address - Country:US
Practice Address - Phone:717-243-0616
Practice Address - Fax:717-245-2351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073929L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1768512OtherHIGHMARK BLUE SHIELD
PA50054276OtherCAPITAL BLUE CROSS
PA2451665000OtherINDEPENDENCE BLUE CROSS
PA1540780OtherGATEWAY HEALTH PLAN