Provider Demographics
NPI:1669144994
Name:NORTH SHORE EAR, NOSE AND THROAT ASSOCIATES
Entity type:Organization
Organization Name:NORTH SHORE EAR, NOSE AND THROAT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:O'CALLAGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-745-6601
Mailing Address - Street 1:104 ENDICOTT ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-0009
Mailing Address - Country:US
Mailing Address - Phone:978-745-6601
Mailing Address - Fax:
Practice Address - Street 1:104 ENDICOTT ST STE 100
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-0009
Practice Address - Country:US
Practice Address - Phone:978-745-6601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty