Provider Demographics
NPI:1902893878
Name:EAR NOSE THROAT PHYSICIANS & SURGEONS PA
Entity Type:Organization
Organization Name:EAR NOSE THROAT PHYSICIANS & SURGEONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:BYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-623-0542
Mailing Address - Street 1:130 TARRYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-2713
Mailing Address - Country:US
Mailing Address - Phone:603-669-0831
Mailing Address - Fax:603-669-4088
Practice Address - Street 1:130 TARRYTOWN RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-2713
Practice Address - Country:US
Practice Address - Phone:603-669-0831
Practice Address - Fax:603-669-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH83043994Medicaid
NH83043994Medicaid