Provider Demographics
NPI:1881615862
Name:EAR CONSULTANTS OF CENTRAL NEW YORK, PLLC
Entity type:Organization
Organization Name:EAR CONSULTANTS OF CENTRAL NEW YORK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CONKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-476-3127
Mailing Address - Street 1:721 E GENESEE ST
Mailing Address - Street 2:FL 2
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1505
Mailing Address - Country:US
Mailing Address - Phone:315-476-3127
Mailing Address - Fax:315-476-3136
Practice Address - Street 1:721 E GENESEE ST
Practice Address - Street 2:FL 2
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1505
Practice Address - Country:US
Practice Address - Phone:315-476-3127
Practice Address - Fax:315-476-3136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY51672AMedicare PIN