MEDICARE: ADVANCED OTOLARYNGOLOGY & ALLERGY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207YS0123X	Facial Plastic Surgery Physician
2	261QM1300X	Multi-Specialty Clinic/Center
3	261QU0200X	Urgent Care Clinic/Center
4	261QH0700X	Hearing and Speech Clinic/Center
5	207Y00000X	Otolaryngology Physician

General Provider Information

NPI Number	:	1457705717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED OTOLARYNGOLOGY & ALLERGY LLC

Provider Business Mailing Address
First Line	:	864 BROADWAY
Second Line	:
City	:	HANOVER
State	:	PA
Zip	:	17331-1501
Country	:	US
Telephone Number	:	717-632-5050
Fax Number	:	717-965-7519

Provider Business Practice Location Address
First Line	:	864 BROADWAY STE 101
Second Line	:
City	:	HANOVER
State	:	PA
Zip	:	17331-1501
Country	:	US
Telephone Number	:	717-632-5050
Fax Number	:	717-965-7519

Authorized Official
Title or Position	:	MD
Name	:	ZAHER SROUR
Credential	:
Telephone Number	:	717-632-2221

Provider Enumeration Date	:	04/22/2016
Last Update Date	:	02/03/2026

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