Provider Demographics
NPI:1215374178
Name:ENT ASSOCIATES
Entity type:Organization
Organization Name:ENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BOGDASARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-342-1200
Mailing Address - Street 1:33 ELECTRIC AVE
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7954
Mailing Address - Country:US
Mailing Address - Phone:978-342-1200
Mailing Address - Fax:978-345-8014
Practice Address - Street 1:33 ELECTRIC AVE
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7954
Practice Address - Country:US
Practice Address - Phone:978-342-1200
Practice Address - Fax:978-345-8014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA33995207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty