=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750320354
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE HEAD AND NECK CENTER PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 311 SOUTH CEDAR CREST BOULEVARD
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-432-8551
-----------------------------------------------------
Fax | 610-432-1384
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 SOUTH CEDAR CREST BOULEVARD
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-432-8551
-----------------------------------------------------
Fax | 610-432-1384
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | EDWARD A TOMKIN
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 610-432-8551
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------