Healthcare Provider Details

I. General information

NPI: 1588692149
Provider Name (Legal Business Name): EAR, NOSE & THROAT SURGICAL ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 MARLTON PIKE E
CHERRY HILL NJ
08003-2118
US

IV. Provider business mailing address

1924 MARLTON PIKE E
CHERRY HILL NJ
08003-2118
US

V. Phone/Fax

Practice location:
  • Phone: 856-424-9200
  • Fax: 856-424-9245
Mailing address:
  • Phone: 856-424-9200
  • Fax: 856-424-9245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: DR. EDWARD DAVID SCHEINER
Title or Position: OWNER/PRES
Credential: D.O
Phone: 856-424-9200