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General NPI Number Information
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NPI Number | 1992864920
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Entity Type | Organization
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Legal Business Name | EAR,NOSE, AND THROAT AND ALLERGY ASSOCIATES, PC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 1336 BRISTOL PIKE SUITE 201
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City | BENSALEM
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State | PA
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Zip | 19020-5660
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Country | US
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Telephone | 215-639-3911
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Fax |
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Provider Business Mailing Address
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Address Line | 1843 INVERNESS DR
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City | YARDLEY
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State | PA
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Zip | 19067-3916
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Country | US
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Telephone | 215-860-7773
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRAD MILLMAN
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Credential |
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Telephone | 215-860-7773
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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 | MD-049066L
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License Number State | PA
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