Healthcare Provider Details

I. General information

NPI: 1225152663
Provider Name (Legal Business Name): ASSOCIATES IN OTOLARYNGOLOGY HEAD AND NECK SURGERY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 03/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MLK JR BLVD STE 4
WORCESTER MA
01608-1209
US

IV. Provider business mailing address

100 MLK JR BLVD STE 4
WORCESTER MA
01608-1209
US

V. Phone/Fax

Practice location:
  • Phone: 508-757-0330
  • Fax: 508-752-9850
Mailing address:
  • Phone: 508-757-0330
  • Fax: 508-754-9426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ANDREA CHIARAMONTE
Title or Position: PRESIDENT
Credential: MD
Phone: 508-757-0330