Provider Demographics
NPI:1053345397
Name:EAR NOSE AND THROAT ASSOCIATES OF CENTRAL PA PC
Entity type:Organization
Organization Name:EAR NOSE AND THROAT ASSOCIATES OF CENTRAL PA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HOWELLS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:814-944-5357
Mailing Address - Street 1:3341 BEALE AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-1549
Mailing Address - Country:US
Mailing Address - Phone:814-944-5357
Mailing Address - Fax:814-946-8017
Practice Address - Street 1:3341 BEALE AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-1549
Practice Address - Country:US
Practice Address - Phone:814-944-5357
Practice Address - Fax:814-946-8017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACH1449OtherMEDICARE RAILROAD
PA838363OtherBLUE SHIELD GROUP ASSIGNM
PACH1449OtherMEDICARE RAILROAD