Provider Demographics
NPI:1235120411
Name:ADVANCED EAR NOSE AND THROAT ASSOCIATES PC
Entity Type:Organization
Organization Name:ADVANCED EAR NOSE AND THROAT ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LEFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-944-3311
Mailing Address - Street 1:9250 N 3RD ST STE 2025
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2404
Mailing Address - Country:US
Mailing Address - Phone:602-944-3311
Mailing Address - Fax:602-944-1968
Practice Address - Street 1:9250 N 3RD ST STE 2025
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2404
Practice Address - Country:US
Practice Address - Phone:602-944-3311
Practice Address - Fax:602-944-1968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty