Provider Demographics
NPI:1740586197
Name:EAR NOSE & THROAT ASSOCIATES PC
Entity Type:Organization
Organization Name:EAR NOSE & THROAT ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHUSING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-468-2205
Mailing Address - Street 1:7001 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:SUITE 260
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3065
Mailing Address - Country:US
Mailing Address - Phone:703-468-2205
Mailing Address - Fax:703-468-2216
Practice Address - Street 1:7001 HERITAGE VILLAGE PLZ
Practice Address - Street 2:SUITE 260
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3065
Practice Address - Country:US
Practice Address - Phone:703-468-2205
Practice Address - Fax:703-468-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101236105207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty