Provider Demographics
NPI:1912941212
Name:SYRACUSE ENT SURGEONS PLLC
Entity Type:Organization
Organization Name:SYRACUSE ENT SURGEONS PLLC
Other - Org Name:PATRICK J CHILES PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHILES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-251-1093
Mailing Address - Street 1:3906 E GENESEE STREET
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1934
Mailing Address - Country:US
Mailing Address - Phone:315-251-1093
Mailing Address - Fax:315-251-1571
Practice Address - Street 1:3906 E GENESEE STREET
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:NY
Practice Address - Zip Code:13214-1934
Practice Address - Country:US
Practice Address - Phone:315-251-1093
Practice Address - Fax:315-251-1093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty