Organization
NORTH SHORE EAR, NOSE & THROAT ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES J LEIDNER MD (PRESIDENT)
(978) 745-6601
Entity
Organization
Contact information
Practice address
55 HIGHLAND AVE, SALEM, MA 01970-2100
(978) 745-6601
(978) 744-4872
Mailing address
55 HIGHLAND AVE, SALEM, MA 01970-2100
(978) 745-6601
(978) 744-4872
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34543
FALLON GROUP NUMBER
MA
01
—
701493
TUFTS GROUP NUMBER
MD
01
—
942871
AETNA GROUP NUMBER
MA
05
—
9719032
—
MA
01
—
C14552
RR MEDICARE GROUP NUMBER
MA
01
—
M13205
BLUE SHIELD GROUP NUMBER
MA
Enumeration date
02/09/2006
Last updated
06/09/2008
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