Provider Demographics
NPI:1821192824
Name:EAR NOSE AND THROAT CONSULTANTS PC
Entity Type:Organization
Organization Name:EAR NOSE AND THROAT CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SAULL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-938-8400
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-938-8400
Mailing Address - Fax:215-938-7013
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 214
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-938-8400
Practice Address - Fax:215-938-7013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0644689000OtherPERSONAL CHOICE
PA740230OtherAMERIHEATH
PA0644689000OtherKEYSTONE
PA0644689000OtherAMERIHEALTH
PA5734211OtherAETNA HMO
PA740230OtherPA BLUE SHIELD
PA0644689000OtherKEYSTONE