Provider Demographics
NPI:1992864920
Name:EAR,NOSE, AND THROAT AND ALLERGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:EAR,NOSE, AND THROAT AND ALLERGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-860-7773
Mailing Address - Street 1:1843 INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-3916
Mailing Address - Country:US
Mailing Address - Phone:215-860-7773
Mailing Address - Fax:
Practice Address - Street 1:1336 BRISTOL PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5660
Practice Address - Country:US
Practice Address - Phone:215-639-3911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-049066L207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty