Provider Demographics
NPI:1780859686
Name:CHESAPEAKE EAR, NOSE, THROAT, SINUS &HEARING CENTER, LLC
Entity Type:Organization
Organization Name:CHESAPEAKE EAR, NOSE, THROAT, SINUS &HEARING CENTER, LLC
Other - Org Name:CHESAPEAKE ENT AUDIOLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-822-1000
Mailing Address - Street 1:29466 PINTAIL DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-9323
Mailing Address - Country:US
Mailing Address - Phone:410-820-9119
Mailing Address - Fax:
Practice Address - Street 1:29466 PINTAIL DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-9323
Practice Address - Country:US
Practice Address - Phone:410-820-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty