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General NPI Number Information
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NPI Number | 1487717575
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Entity Type | Organization
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Legal Business Name | OTOLARYNGOLOGY PLASTIC SURGERY ASSOCIATES, PC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 2100 N BROAD ST
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City | LANSDALE
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State | PA
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Zip | 19446-1052
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Country | US
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Telephone | 215-368-5290
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Fax | 215-348-7416
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Provider Business Mailing Address
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Address Line | 2100 N BROAD ST
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City | LANSDALE
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State | PA
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Zip | 19446-1052
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Country | US
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Telephone | 215-368-5290
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Fax | 215-348-7416
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MAUREEN MASTURZO
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Credential |
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Telephone | 215-348-1152
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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 |
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License Number State |
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