Provider Demographics
NPI:1972541589
Name:OTOLARYNGOLOGY ASSOCIATES
Entity type:Organization
Organization Name:OTOLARYNGOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:EINHORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-886-1482
Mailing Address - Street 1:1245 HIGHLAND AVE
Mailing Address - Street 2:SUITE 502
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-3714
Mailing Address - Country:US
Mailing Address - Phone:215-886-1482
Mailing Address - Fax:215-886-1491
Practice Address - Street 1:1245 HIGHLAND AVE
Practice Address - Street 2:SUITE 502
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3714
Practice Address - Country:US
Practice Address - Phone:215-886-1482
Practice Address - Fax:215-886-1491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0664403Medicaid
PA0664403Medicaid