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General NPI Number Information
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NPI Number | 1801971817
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Entity Type | Organization
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Legal Business Name | FAMILY EAR NOSE AND THROAT CARE PC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 5010 STATE HIGHWAY 30 SUITE 204
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City | AMSTERDAM
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State | NY
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Zip | 12010
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Country | US
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Telephone | 518-842-8185
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Fax | 518-842-8189
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Provider Business Mailing Address
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Address Line | 5010 STATE HIGHWAY 30 SUITE 204
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City | AMSTERDAM
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State | NY
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Zip | 12010
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Country | US
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Telephone | 518-842-8185
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Fax | 518-842-8189
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DENISE D COOK
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Credential |
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Telephone | 518-842-8185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0602X
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Taxonomy Name | Otolaryngic Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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