Provider Demographics
NPI:1356306195
Name:BETHLEHEM EAR, NOSE & THROAT ASSOCIATES
Entity Type:Organization
Organization Name:BETHLEHEM EAR, NOSE & THROAT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:HUNSICKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-866-5555
Mailing Address - Street 1:3445 HIGHPOINT BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017
Mailing Address - Country:US
Mailing Address - Phone:610-866-5555
Mailing Address - Fax:610-866-2006
Practice Address - Street 1:3445 HIGHPOINT BLVD
Practice Address - Street 2:STE 100
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017
Practice Address - Country:US
Practice Address - Phone:610-866-5555
Practice Address - Fax:610-866-2006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-17
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042601Medicare PIN