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General NPI Number Information
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NPI Number | 1952372237
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Entity Type | Organization
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Legal Business Name | GREENSBORO EAR NOSE & THROAT ASSOCIATES PA
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 07/01/2010
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Provider Practice Location Address
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Address Line | 1132 N CHURCH ST SUITE 200
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City | GREENSBORO
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State | NC
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Zip | 27401-1039
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Country | US
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Telephone | 336-358-4268
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Fax | 336-544-7180
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Provider Business Mailing Address
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Address Line | 1132 N CHURCH ST SUITE 200
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City | GREENSBORO
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State | NC
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Zip | 27401-1039
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Country | US
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Telephone | 336-358-4268
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Fax | 336-544-7180
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Authorized Official
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Title or Position | TREASURER
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Name | MR. JEFRY H ROSEN I
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Credential | MD
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Telephone | 336-358-4268
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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 | 39952
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License Number State | NC
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