MAIN LINE EAR NOSE & THROAT PC NPI 1780830620

NPI Information

NPI: 1780830620
Provider Name: MAIN LINE EAR, NOSE & THROAT, PC
Classification: Otolaryngology - 207YS0123X
Entity Type: Organization

Specialization: Facial Plastic Surgery

CLIA Number: 39D0202826

Address:
17 INDUSTRIAL BLVD
SUITE 102
PAOLI, PA
ZIP 19301
Phone: (610) 647-3727
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MAIN LINE EAR, NOSE & THROAT, PC is a facial plastic surgery otolaryngology in Paoli, PA. The provider is an otolaryngologist who specializes in facial plastic surgery. MAIN LINE EAR, NOSE & THROAT, PC NPI is 1780830620. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17 INDUSTRIAL BLVD
SUITE 102
PAOLI, PA
ZIP 19301-607
Phone: (610) 647-3727
Fax: (610) 647-4969

The provider's authorized official is Christopher Randall Hove .
The authorized official title is Physician Owner and has the following contact phone number (610) 647-3727.

The CLIA number assigned to this NPI record is 39D0202826 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 8/12/2008 and was last updated on 3/16/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	231H00000X	Audiologist			PENNSYLVANIA	No
2	207YS0123X	Otolaryngology	Facial Plastic Surgery	MD431700	PENNSYLVANIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	148772	MEDICARE PIN	PENNSYLVANIA
2	102498645-0001	MEDICAID	PENNSYLVANIA

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: 5/5/2024

NPI Synchronization or Removal

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