Provider Demographics
NPI:1497807176
Name:EAR, NOSE & THROAT ASSOCIATES OF ONEONTA, PC
Entity Type:Organization
Organization Name:EAR, NOSE & THROAT ASSOCIATES OF ONEONTA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-432-1355
Mailing Address - Street 1:41-45 DIETZ ST
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-1855
Mailing Address - Country:US
Mailing Address - Phone:607-432-1355
Mailing Address - Fax:607-433-6654
Practice Address - Street 1:41-45 DIETZ ST
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-1855
Practice Address - Country:US
Practice Address - Phone:607-432-1355
Practice Address - Fax:607-433-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY153630207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY10032809OtherCDPDP PROVIDER NUMBER
NYCM2672OtherRAILROAD MEDICARE
NY00786489Medicaid
NY048013OtherMVP PROVIDER NUMBER
NYD76925Medicare UPIN
NY39195AMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER