MEDICARE: CARLISLE EAR NOSE & THROAT ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	MD073929L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1768512	OTHER	PA	HIGHMARK BLUE SHIELD
2	50054276	OTHER	PA	CAPITAL BLUE CROSS
3	2451665000	OTHER	PA	INDEPENDENCE BLUE CROSS
4	1540780	OTHER	PA	GATEWAY HEALTH PLAN

General Provider Information

NPI Number	:	1174631733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLISLE EAR NOSE & THROAT ASSOCIATES

Provider Business Mailing Address
First Line	:	9 BROOKWOOD AVE
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-9126
Country	:	US
Telephone Number	:	717-243-0616
Fax Number	:	717-245-2351

Provider Business Practice Location Address
First Line	:	9 BROOKWOOD AVE
Second Line	:
City	:	CARLISLE
State	:	PA
Zip	:	17015-9126
Country	:	US
Telephone Number	:	717-243-0616
Fax Number	:	717-245-2351

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD EDWARD FERRARO
Credential	:	MD
Telephone Number	:	717-243-0616

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	10/01/2013

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Directions to “CARLISLE EAR NOSE & THROAT ASSOCIATES ” Practice Location

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