Provider Demographics
NPI:1255414967
Name:ENT & ALLERGY CENTER, P.A.
Entity type:Organization
Organization Name:ENT & ALLERGY CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:302-629-3400
Mailing Address - Street 1:8468 HERRING RUN RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-5763
Mailing Address - Country:US
Mailing Address - Phone:302-629-3400
Mailing Address - Fax:302-629-5300
Practice Address - Street 1:8468 HERRING RUN RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-5763
Practice Address - Country:US
Practice Address - Phone:302-629-3400
Practice Address - Fax:302-629-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC20003456207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2028329000OtherAMERIHEALTH
DE0001157304Medicaid
DE001157304OtherDPCI
DE040016600OtherRAILROAD MEDICARE
00A820E83OtherMEDICARE PROVIDER NUMBER
DEE70145OtherUPIN
DE001157304OtherDPCI
DE2028329000OtherAMERIHEALTH
DE=========OtherAETNA
DE=========OtherCIGNA
DE=========OtherTRICARE
DE=========OtherALLIANCE, MAMSI, OPT CHOI