Healthcare Provider Details

I. General information

NPI: 1932151198
Provider Name (Legal Business Name): TRIANGLE E N T SERVICES ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 08/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4210 N ROXBORO ST SUITE 140
DURHAM NC
27704-1874
US

IV. Provider business mailing address

4210 N ROXBORO ST SUITE 140
DURHAM NC
27704-1874
US

V. Phone/Fax

Practice location:
  • Phone: 919-620-7800
  • Fax: 919-620-7807
Mailing address:
  • Phone: 919-620-7800
  • Fax: 919-620-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2355A2700X
TaxonomyAudiology Assistant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT E TAYLOR
Title or Position: PRESIDENT
Credential: MD
Phone: 919-620-7800