Organization
EAR NOSE AND THROAT SPECIALISTS OF NORTHWESTERN PENNSYLVANIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT M BUDACKI (PRACTICE ADMINISTRATOR)
(814) 864-9994
Entity
Organization
Contact information
Practice address
1645 W 8TH ST, SUITE 200, ERIE, PA 16505-5007
(814) 864-9994
(814) 866-2655
Mailing address
1645 W 8TH ST, SUITE 200, ERIE, PA 16505-5007
(814) 864-9994
(814) 866-2655
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01402146
—
PA
01
—
CI4811
RAILROAD MEDICARE
—
Enumeration date
07/02/2006
Last updated
04/14/2015
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