Provider Demographics
NPI:1699953034
Name:FREEHOLD EAR NOSE & THROAT ASSOCIATES, PA
Entity type:Organization
Organization Name:FREEHOLD EAR NOSE & THROAT ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-431-1666
Mailing Address - Street 1:222 SCHANCK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3068
Mailing Address - Country:US
Mailing Address - Phone:732-431-1666
Mailing Address - Fax:731-431-1665
Practice Address - Street 1:222 SCHANCK RD
Practice Address - Street 2:SUITE200
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3068
Practice Address - Country:US
Practice Address - Phone:732-431-1666
Practice Address - Fax:731-431-1665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02666400174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ526316Medicare PIN