Healthcare Provider Details

I. General information

NPI: 1588852198
Provider Name (Legal Business Name): EAR, NOSE, THROAT, AND ALLERGY ASSOCIATES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 SILVERSIDE RD SUITE 3A
WILMINGTON DE
19810-3719
US

IV. Provider business mailing address

2700 SILVERSIDE RD SUITE 3A
WILMINGTON DE
19810-3719
US

V. Phone/Fax

Practice location:
  • Phone: 302-478-9878
  • Fax: 302-478-8069
Mailing address:
  • Phone: 302-478-9878
  • Fax: 302-478-8069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: CINDY IMBER
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-478-9878