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General NPI Number Information
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NPI Number | 1437260114
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Entity Type | Organization
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Legal Business Name | ASSOCIATES IN EAR, NOSE AND THROAT OF GREATER NASHUA, PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17 RIVERSIDE ST SUITE104
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City | NASHUA
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State | NH
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Zip | 03062-1304
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Country | US
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Telephone | 603-882-8923
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Fax | 603-882-3936
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Provider Business Mailing Address
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Address Line | 17 RIVERSIDE ST SUITE104
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City | NASHUA
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State | NH
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Zip | 03062-1304
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Country | US
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Telephone | 603-882-8923
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Fax | 603-882-3936
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | DR. EDWARD DENNIS DONOVAN
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Credential | M.D.
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Telephone | 603-882-8923
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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 | 7761
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License Number State | NH
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