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General NPI Number Information
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NPI Number | 1427157296
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Entity Type | Organization
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Legal Business Name | LONGWOOD OTOLARYNGOLOGY
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1223 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-5302
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Country | US
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Telephone | 617-975-2800
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Fax | 617-975-2825
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Provider Business Mailing Address
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Address Line | 1223 BEACON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-5302
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Country | US
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Telephone | 617-975-2800
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Fax | 617-975-2825
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT ANDREW FRANKENTHALER
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Credential | M.D.
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Telephone | 617-975-2800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 79762
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License Number State | MA
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