Provider Demographics
NPI:1326212523
Name:WATERS, HEATHER HOLMES (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:HOLMES
Last Name:WATERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5528 MAIN ST
Mailing Address - Street 2:ENT ASSOCIATES OF NEW YORK
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5044
Mailing Address - Country:US
Mailing Address - Phone:718-445-5100
Mailing Address - Fax:718-886-7466
Practice Address - Street 1:761 MAIN AVE STE 101
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-845-2244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY272636207YX0905X
CT62438207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery