Healthcare Provider Details

I. General information

NPI: 1083906465
Provider Name (Legal Business Name): WASHINGTON EAR, NOSE AND THROAT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 LANDINGS DR STE 207
WASHINGTON PA
15301-9408
US

IV. Provider business mailing address

80 LANDINGS DR STE 207
WASHINGTON PA
15301-9408
US

V. Phone/Fax

Practice location:
  • Phone: 724-225-8995
  • Fax: 724-225-9874
Mailing address:
  • Phone: 724-225-8995
  • Fax: 724-225-9874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License NumberD00808
License Number StatePA

VIII. Authorized Official

Name: MRS. LESLIE ZAJDEL
Title or Position: OFFICE MANAGER
Credential:
Phone: 724-225-8995