Healthcare Provider Details

I. General information

NPI: 1497807176
Provider Name (Legal Business Name): EAR, NOSE & THROAT ASSOCIATES OF ONEONTA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41-45 DIETZ ST
ONEONTA NY
13820-1855
US

IV. Provider business mailing address

41-45 DIETZ ST
ONEONTA NY
13820-1855
US

V. Phone/Fax

Practice location:
  • Phone: 607-432-1355
  • Fax: 607-433-6654
Mailing address:
  • Phone: 607-432-1355
  • Fax: 607-433-6654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License Number153630
License Number StateNY

VIII. Authorized Official

Name: JOHN PAUL SWEET
Title or Position: PRESIDENT
Credential: M.D.
Phone: 607-432-1355