Provider Demographics
NPI:1295727279
Name:UNIVERSITY EAR NOSE AND THROAT OF NORTHEASTERN NEW YORK LLP
Entity type:Organization
Organization Name:UNIVERSITY EAR NOSE AND THROAT OF NORTHEASTERN NEW YORK LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARNES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-262-5575
Mailing Address - Street 1:PO BOX 8836
Mailing Address - Street 2:UNIVERSITY ENT OF NENY
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-0836
Mailing Address - Country:US
Mailing Address - Phone:518-262-5575
Mailing Address - Fax:
Practice Address - Street 1:35 HACKETT BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3420
Practice Address - Country:US
Practice Address - Phone:518-262-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AA1697Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
NYWER711Medicare PIN