Provider Demographics
NPI:1932151198
Name:TRIANGLE E N T SERVICES ASSOCIATION INC
Entity Type:Organization
Organization Name:TRIANGLE E N T SERVICES ASSOCIATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-620-7800
Mailing Address - Street 1:4210 N ROXBORO ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-1874
Mailing Address - Country:US
Mailing Address - Phone:919-620-7800
Mailing Address - Fax:919-620-7807
Practice Address - Street 1:4210 N ROXBORO ST
Practice Address - Street 2:SUITE 140
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-1874
Practice Address - Country:US
Practice Address - Phone:919-620-7800
Practice Address - Fax:919-620-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890219VMedicaid
NC0219VOtherBLUE CROSS BLUE SHIELD
2344766Medicare ID - Type Unspecified