MEDICARE: ADVANCED EAR NOSE AND THROAT ASSOCIATES PC

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

General Provider Information

NPI Number	:	1235120411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED EAR NOSE AND THROAT ASSOCIATES PC

Provider Business Mailing Address
First Line	:	9250 N 3RD ST STE 2025
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2404
Country	:	US
Telephone Number	:	602-944-3311
Fax Number	:	602-944-1968

Provider Business Practice Location Address
First Line	:	9250 N 3RD ST STE 2025
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85020-2404
Country	:	US
Telephone Number	:	602-944-3311
Fax Number	:	602-944-1968

Authorized Official
Title or Position	:	OWNER
Name	:	BEN E LEFF
Credential	:	MD
Telephone Number	:	602-944-3311

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	05/03/2021

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