Organization
CEDAR CREST ENT ASSOCIATES P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE H GAYLOR M.D. (M.D./PRESIDENT)
(610) 770-9797
Entity
Organization
Contact information
Practice address
1251 S CEDAR CREST BLVD, SUITE 100, ALLENTOWN, PA 18103-6205
(610) 770-9797
(610) 770-9521
Mailing address
1251 S CEDAR CREST BLVD, SUITE 100, ALLENTOWN, PA 18103-6205
(610) 770-9797
(610) 770-9521
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
MD022099E
PA
207YP0228X
Pediatric Otolaryngology Physician
MD022099E
PA
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
MD022099E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02348200
CAPITAL BLUE CROSS
PA
01
—
0549870
AETNA US HEALTHCARE
PA
Enumeration date
04/05/2006
Last updated
02/27/2008
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