Healthcare Provider Details

I. General information

NPI: 1902893878
Provider Name (Legal Business Name): EAR NOSE THROAT PHYSICIANS & SURGEONS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2005
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 TARRYTOWN RD
MANCHESTER NH
03103-2713
US

IV. Provider business mailing address

130 TARRYTOWN RD
MANCHESTER NH
03103-2713
US

V. Phone/Fax

Practice location:
  • Phone: 603-669-0831
  • Fax: 603-669-4088
Mailing address:
  • Phone: 603-669-0831
  • Fax: 603-669-4088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFFREY BYER
Title or Position: OWNER/MEDICAL DOCTOR
Credential: MD
Phone: 603-623-0542