Provider Demographics
NPI:1881880813
Name:SHARON EAR, NOSE AND THROAT, PC
Entity type:Organization
Organization Name:SHARON EAR, NOSE AND THROAT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARI
Authorized Official - Middle Name:J
Authorized Official - Last Name:NAMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-364-1264
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-0617
Mailing Address - Country:US
Mailing Address - Phone:860-364-1264
Mailing Address - Fax:860-364-2074
Practice Address - Street 1:29 HOSPITAL HILL RD
Practice Address - Street 2:SUITE 1900
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2095
Practice Address - Country:US
Practice Address - Phone:860-364-1264
Practice Address - Fax:860-364-2074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034947207YS0123X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2086671Medicaid
CT001349473Medicaid
CT001349473Medicaid
F41280Medicare UPIN
MAA37701Medicare PIN