Organization
NORTH BAY ENT & AUDIOLOGY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MALVASO (ADMINISTRATOR)
(410) 879-9100
Entity
Organization
Contact information
Practice address
456 ALLIANCE ST, HAVRE DE GRACE, MD 21078-3559
(410) 939-1819
Mailing address
520 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4339
(410) 879-9100
(410) 638-0408
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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