Provider Demographics
NPI:1730397266
Name:ENT SURGICAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ENT SURGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOHN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-459-5030
Mailing Address - Street 1:558 NORTH CHURCH ST. SUITE 20
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201-3188
Mailing Address - Country:US
Mailing Address - Phone:570-459-5030
Mailing Address - Fax:570-459-5022
Practice Address - Street 1:558 NORTH CHURCH ST. SUITE 20
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-3188
Practice Address - Country:US
Practice Address - Phone:570-459-5030
Practice Address - Fax:570-459-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0093562207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2546381OtherAETNA