Provider Demographics
NPI:1962492090
Name:GREATER MILFORD EAR NOSE AND THROAT HEAD AND NECK SURGERY INC
Entity Type:Organization
Organization Name:GREATER MILFORD EAR NOSE AND THROAT HEAD AND NECK SURGERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-478-0555
Mailing Address - Street 1:42 CAPE RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3292
Mailing Address - Country:US
Mailing Address - Phone:508-478-0555
Mailing Address - Fax:508-473-5088
Practice Address - Street 1:42 CAPE RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3292
Practice Address - Country:US
Practice Address - Phone:508-478-0555
Practice Address - Fax:508-473-5088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty