Provider Demographics
NPI:1902575129
Name:ENT SINUS AND SLEEP CENTER
Entity Type:Organization
Organization Name:ENT SINUS AND SLEEP CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MAZZONI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-721-8292
Mailing Address - Street 1:1253 SPRINGFIELD AVE STE 351
Mailing Address - Street 2:
Mailing Address - City:NEW PROVIDENCE
Mailing Address - State:NJ
Mailing Address - Zip Code:07974-2931
Mailing Address - Country:US
Mailing Address - Phone:732-574-1777
Mailing Address - Fax:732-574-2707
Practice Address - Street 1:15 PROSPECT LN STE 2G
Practice Address - Street 2:
Practice Address - City:COLONIA
Practice Address - State:NJ
Practice Address - Zip Code:07067-3048
Practice Address - Country:US
Practice Address - Phone:732-574-1777
Practice Address - Fax:732-574-2707
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENT SINUS AND SLEEP CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-10
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Single Specialty