Provider Demographics
NPI:1437112224
Name:OTORHINOLARYNGOLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:OTORHINOLARYNGOLOGY ASSOCIATES, P.C.
Other - Org Name:ORL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:WAKSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-824-5050
Mailing Address - Street 1:217 FRANKLIN AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071-1509
Mailing Address - Country:US
Mailing Address - Phone:610-824-5050
Mailing Address - Fax:610-824-5053
Practice Address - Street 1:217 FRANKLIN AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-1509
Practice Address - Country:US
Practice Address - Phone:610-824-5050
Practice Address - Fax:610-824-5053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & NeurotologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA03247700OtherCAPITAL BLUE CROSS
PA1468418OtherBLUE SHIELD
PADA0683OtherRAILROAD MEDICARE