Healthcare Provider Details

I. General information

NPI: 1285620609
Provider Name (Legal Business Name): EAR, NOSE & THROAT ASSOCIATES OF WORCESTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 SOUTHBRIDGE RD
CHARLTON MA
01507-5237
US

IV. Provider business mailing address

246 SOUTHBRIDGE RD
CHARLTON MA
01507-5237
US

V. Phone/Fax

Practice location:
  • Phone: 508-980-7074
  • Fax: 508-434-0821
Mailing address:
  • Phone: 508-980-7074
  • Fax: 508-434-0821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER C CHARON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 508-791-6305