Organization
UNIVERSITY OTOLARYNGOLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW JOEL NAGORSKY MD (PRESIDENT)
(215) 762-4600
Entity
Organization
Contact information
Practice address
205 N BROAD ST, SUITE 401, PHILADELPHIA, PA 19107-1554
(215) 762-4600
(215) 988-0733
Mailing address
205 N BROAD ST, SUITE 401, PHILADELPHIA, PA 19107-1554
(215) 762-4600
(215) 988-0733
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
207YX0602X
Otolaryngic Allergy Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018866300
—
PA
01
—
CG0580
RAIL ROAD MEDICARE
PA
Enumeration date
04/13/2006
Last updated
02/03/2020
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