Ear Nose & Throat Allergy & Facial Plastic Surgery Specialists LLC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

EAR NOSE & THROAT ALLERGY & FACIAL PLASTIC SURGERY SPECIALISTS LLC

Practice address

2600 Post Rd
Southport, CT 06890-1258

Phone

(203) 256-3338

Fax

(203) 256-3346

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Bradford Stephen Chervin, MD

Title

Member & Manager

Phone

(203) 256-3338

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1609942382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 POST RD",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901258",
            "telephone_number": "203-256-3338",
            "fax_number": "203-256-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 POST RD",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901258",
            "telephone_number": "203-256-3338",
            "fax_number": "203-256-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE & THROAT ALLERGY & FACIAL PLASTIC SURGERY SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "CHERVIN",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "MEMBER & MANAGER",
        "authorized_official_telephone_number": "203-256-3338",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Otolaryngology Physician in Southport, CT
• Providers in Southport, CT by specialty
• Otolaryngology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.