Providence Ear Nose & Throat Associates INC

NPI #1134680747 in Media, Pennsylvania

Provider Information

NPI Number: 1134680747
Entity Type: Organization
Organization Name: Providence Ear Nose & Throat Associates INC
Primary Specialty: Otolaryngology
Enumeration Date: Mar 27, 2019
Last Updated: Apr 14, 2021

Practice Location

Address: RIDDLE MEM. HOSP.- OUTPT. PAV.
Address 2: 1098 W. BALTIMORE PK. STE 3406
City: Media
State: Pennsylvania
ZIP Code: 19063-5139
Phone: (610) 874-5366

Authorized Official

Name: JOHN M FEEHERY, MD
Title: AUTHORIZED OFFICIAL
Phone: (610) 874-5366

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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