Provider Demographics
NPI:1588740245
Name:ACCENT HEAD AND NECK GROUP, PA
Entity type:Organization
Organization Name:ACCENT HEAD AND NECK GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELORIO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-926-5556
Mailing Address - Street 1:2021 NEW RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1045
Mailing Address - Country:US
Mailing Address - Phone:609-926-5556
Mailing Address - Fax:609-926-5355
Practice Address - Street 1:2021 NEW RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1045
Practice Address - Country:US
Practice Address - Phone:609-926-5556
Practice Address - Fax:609-926-5355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06497500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2397210OtherAETNA HMO#
NJCH5347OtherRAILROAD MEDICARE GROUP #
NY0132139000OtherAMERIHEALTH GROUP #
NY5826793OtherAETNA PPO#
NJ2397210OtherAETNA HMO#
NJ2397210OtherAETNA HMO#