NPIMap

Organization Active NPI

Ear Nose & Throat Medicine & Surgery of Portsmouth PA

  • Otolaryngology Physician
  • Portsmouth, NH
National Provider Identifier
1720208820
Registry record updated Nov 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
NH5840 Issued in NH
Legal business name
EAR NOSE & THROAT MEDICINE & SURGERY OF PORTSMOUTH PA
Practice address
330 Borthwick Ave
Suite 304
Portsmouth, NH 03801-7109
Phone
(603) 431-3477
Fax
(603) 430-9663
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2012

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

Authorized official

Name
Dr. Edmond Y Yeganeh, MDNPI 1902870256
Title
Owner/Officer
Phone
(603) 431-3477

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X NH5840 NH Primary

Addresses

Primary practice location

330 Borthwick Ave
Suite 304
Portsmouth, NH 03801-7109

Mailing address

330 Borthwick Ave
Suite 304
Portsmouth, NH 03801-7109
Phone (603) 431-3477

Other identifiers 1

IdentifierTypeStateIssuer
30010589MedicaidNH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1720208820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BORTHWICK AVE",
            "address_2": "SUITE 304",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017109",
            "telephone_number": "603-431-3477",
            "fax_number": "603-430-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BORTHWICK AVE",
            "address_2": "SUITE 304",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017109",
            "telephone_number": "603-431-3477",
            "fax_number": "603-430-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAR NOSE & THROAT MEDICINE & SURGERY OF PORTSMOUTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "YEGANEH",
        "authorized_official_first_name": "EDMOND",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "OWNER/OFFICER",
        "authorized_official_telephone_number": "603-431-3477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "NH",
            "license": "NH5840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30010589",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.