Healthcare Provider Details

I. General information

NPI: 1922208875
Provider Name (Legal Business Name): ENGLEWOOD EAR NOSE & THROAT PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 ENGLE ST STE 101
ENGLEWOOD NJ
07631-2444
US

IV. Provider business mailing address

216 ENGLE ST STE 101
ENGLEWOOD NJ
07631-2444
US

V. Phone/Fax

Practice location:
  • Phone: 201-816-9800
  • Fax: 207-567-1569
Mailing address:
  • Phone: 201-816-9800
  • Fax: 207-567-1569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: BRYAN T HO
Title or Position: OWNER
Credential: MD
Phone: 201-816-9800