NPIMap

Organization Active NPI

Tri County Ear Nose & Throat PC

  • Otolaryngology Physician
  • Honesdale, PA
National Provider Identifier
1043329030
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
TRI COUNTY EAR NOSE & THROAT PC
Practice address
650 Park St
Honesdale, PA 18431
Phone
(570) 253-0202
Fax
(570) 253-1701
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Philip G Liu, MDNPI 1316055122
Title
Owner
Phone
(570) 253-0202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

650 Park St
Honesdale, PA 18431

Mailing address

650 Park St
Honesdale, PA 18431
Phone (570) 253-0202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080710000196 PA Part B Supplier - Clinic/Group Practice 7719059625 Receives reassigned benefits from 3 practitioners
Practice locations: Honesdale, PA; Milford, PA
O20090316000308 NY Part B Supplier - Clinic/Group Practice 7719059625 Receives reassigned benefits from 2 practitioners
Practice locations: Port Jervis, NY

National Provider Directory

National Provider Directory

Locations

650 Park St
Honesdale, PA 18431
Phone (570) 253-0202

184 Route 6 and 209
Milford, PA 18337
Phone (570) 491-5255

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449619200000",
    "number": "1043329030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "18431",
            "telephone_number": "570-253-0202",
            "fax_number": "570-253-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PARK ST",
            "city": "HONESDALE",
            "state": "PA",
            "postal_code": "18431",
            "telephone_number": "570-253-0202",
            "fax_number": "570-253-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY EAR NOSE & THROAT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-12-09",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-253-0202",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honesdale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.