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General NPI Number Information
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NPI Number | 1497807176
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Entity Type | Organization
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Legal Business Name | EAR, NOSE & THROAT ASSOCIATES OF ONEONTA, PC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 41-45 DIETZ ST
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City | ONEONTA
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State | NY
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Zip | 13820-1855
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Country | US
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Telephone | 607-432-1355
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Fax | 607-433-6654
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Provider Business Mailing Address
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Address Line | 41-45 DIETZ ST
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City | ONEONTA
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State | NY
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Zip | 13820-1855
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Country | US
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Telephone | 607-432-1355
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Fax | 607-433-6654
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN PAUL SWEET
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Credential | M.D.
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Telephone | 607-432-1355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 153630
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License Number State | NY
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