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General NPI Number Information
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NPI Number | 1346289261
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Entity Type | Organization
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Legal Business Name | ALLEN EAR NOSE & THROAT ASSOC
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 10/26/2010
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Provider Practice Location Address
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Address Line | 1575 POND RD STE 203
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City | ALLENTOWN
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State | PA
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Zip | 18104-2254
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Country | US
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Telephone | 610-366-1366
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 POND RD STE 203
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City | ALLENTOWN
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State | PA
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Zip | 18104-2254
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Country | US
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Telephone | 610-366-1366
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | THOMAS KOCH
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Credential | MD
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Telephone | 610-366-1366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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