Organization
ACADEMIC OTOLARYNGOLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAHMOUD GHADERI D.O. (PROPRIETOR)
(484) 494-5595
Entity
Organization
Contact information
Practice address
1501 LANSDOWNE AVE STE 209, DARBY, PA 19023-1333
(484) 494-5515
Mailing address
175 W COHAWKIN RD STE C, CLARKSBORO, NJ 08020-1145
(856) 423-7700
(856) 423-0823
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
OS008674L
PA
Other
Enumeration date
01/24/2014
Last updated
01/24/2014
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