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EAR NOSE & THROAT ALLERGY & FACIAL PLASTIC SURGERY SPECIALISTS LLC NPI 1609942382


NPI Information

NPI: 1609942382
Provider Name: EAR NOSE & THROAT ALLERGY & FACIAL PLASTIC SURGERY SPECIALISTS LLC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 07D0099631

Address:
2600 POST RD
SOUTHPORT, CT
ZIP 06890
Phone: (203) 256-3338
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EAR NOSE & THROAT ALLERGY & FACIAL PLASTIC SURGERY SPECIALISTS LLC is an otolaryngology in Southport, CT. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. EAR NOSE & THROAT ALLERGY & FACIAL PLASTIC SURGERY SPECIALISTS LLC NPI is 1609942382. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2600 POST RD
SOUTHPORT, CT
ZIP 06890-258
Phone: (203) 256-3338
Fax: (203) 256-3346

The provider's authorized official is Bradford Stephen Chervin .
The authorized official title is Member & Manager and has the following contact phone number (203) 256-3338.

The CLIA number assigned to this NPI record is 07D0099631 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/27/2006 and was last updated on 6/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1040000347MEDICARE PINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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