Provider Demographics
NPI:1669522298
Name:MINEOLA EAR, NOSE & THROAT-HEAD & NECK ASSOCIATES
Entity type:Organization
Organization Name:MINEOLA EAR, NOSE & THROAT-HEAD & NECK ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DURANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-294-9363
Mailing Address - Street 1:134 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3959
Mailing Address - Country:US
Mailing Address - Phone:516-294-9363
Mailing Address - Fax:516-294-6228
Practice Address - Street 1:134 MINEOLA BLVD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3959
Practice Address - Country:US
Practice Address - Phone:516-294-9363
Practice Address - Fax:516-294-6228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH23135Medicare UPIN
NYG49429Medicare UPIN
NYB15607Medicare UPIN