Healthcare Provider Details

I. General information

NPI: 1669522298
Provider Name (Legal Business Name): MINEOLA EAR, NOSE & THROAT-HEAD & NECK ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 MINEOLA BLVD
MINEOLA NY
11501-3959
US

IV. Provider business mailing address

134 MINEOLA BLVD
MINEOLA NY
11501-3959
US

V. Phone/Fax

Practice location:
  • Phone: 516-294-9363
  • Fax: 516-294-6228
Mailing address:
  • Phone: 516-294-9363
  • Fax: 516-294-6228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ANTHONY J DURANTE
Title or Position: M.D.
Credential: M.D.
Phone: 516-294-9363