Organization
PROVIDENCE EAR NOSE & THROAT ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M FEEHERY MD (AUTHORIZED OFFICIAL)
(610) 874-5366
Entity
Organization
Contact information
Practice address
RIDDLE MEM. HOSP.- OUTPT. PAV., 1098 W. BALTIMORE PK. STE 3406, MEDIA, PA 19063-5139
(610) 874-5366
(610) 874-8448
Mailing address
2112 PROVIDENCE AVE, CHESTER, PA 19013-5507
(610) 874-5366
(610) 874-8448
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
04/14/2021
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