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General NPI Number Information
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NPI Number | 1689772287
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Entity Type | Organization
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Legal Business Name | EAR NOSE & THROAT MEDICINE AND SURGERY GROUP, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 05/01/2015
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Provider Practice Location Address
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Address Line | 850 AQUIDNECK AVE
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City | MIDDLETOWN
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State | RI
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Zip | 02842-7244
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Country | US
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Telephone | 401-849-4448
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Fax | 401-849-6479
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Provider Business Mailing Address
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Address Line | 850 AQUIDNECK AVE
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City | MIDDLETOWN
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State | RI
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Zip | 02842-7244
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Country | US
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Telephone | 401-849-4448
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Fax | 401-849-6479
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DEBORAH A MURPHY
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Credential |
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Telephone | 401-849-4448
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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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