Provider Demographics
NPI:1376633396
Name:DUTCHESS EAR NOSE AND THROAT PC
Entity Type:Organization
Organization Name:DUTCHESS EAR NOSE AND THROAT PC
Other - Org Name:PERSONAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MELTZER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-473-8600
Mailing Address - Street 1:102 FULTON AVE
Mailing Address - Street 2:STE D
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603
Mailing Address - Country:US
Mailing Address - Phone:845-473-8600
Mailing Address - Fax:845-473-8654
Practice Address - Street 1:102 FULTON AVE
Practice Address - Street 2:STE D
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603
Practice Address - Country:US
Practice Address - Phone:845-473-8600
Practice Address - Fax:845-473-8654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY147245207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B10563Medicare UPIN
W39741Medicare ID - Type Unspecified