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General NPI Number Information
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NPI Number | 1881664167
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Entity Type | Organization
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Legal Business Name | BORAN & PUZZI EAR, NOSE & THROAT ASSOCIATES, PC
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 100 SCHUYLKILL MEDICAL PLZ SUITE 205
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City | POTTSVILLE
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State | PA
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Zip | 17901-3663
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Country | US
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Telephone | 570-621-5010
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Fax | 570-628-2525
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Provider Business Mailing Address
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Address Line | 100 SCHUYLKILL MEDICAL PLZ SUITE 205
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City | POTTSVILLE
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State | PA
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Zip | 17901-3663
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Country | US
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Telephone | 570-621-5010
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Fax | 570-628-2525
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Authorized Official
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Title or Position | PARTNER
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Name | THOMAS BORAN SR.
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Credential | MD
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Telephone | 570-621-5010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AT0008696L
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License Number State | PA
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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 | MD030208E
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License Number State | PA
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