Provider Demographics
NPI:1659343101
Name:ENT & ALLERGY SPECIALISTS OF WESTERN PA, P.C.
Entity Type:Organization
Organization Name:ENT & ALLERGY SPECIALISTS OF WESTERN PA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FROMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS FAAOA
Authorized Official - Phone:412-741-8468
Mailing Address - Street 1:301 OHIO RIVER BLVD
Mailing Address - Street 2:STE 202, EDGEWORTH MEDICAL COMMONS
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143
Mailing Address - Country:US
Mailing Address - Phone:412-741-2122
Mailing Address - Fax:412-741-5417
Practice Address - Street 1:301 OHIO RIVER BLVD
Practice Address - Street 2:STE 202, EDGEWORTH MEDICAL COMMONS
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143
Practice Address - Country:US
Practice Address - Phone:412-741-2122
Practice Address - Fax:412-741-5417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0680200Medicaid
175243OtherHIGHMARK
PA0680200Medicaid
175243OtherHIGHMARK