WATERTOWN EAR NOSE AND THROAT GRP (NPI# 1407948011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407948011 |
| Entity Type | Organization |
| Organization Name | WATERTOWN EAR NOSE AND THROAT GRP |
| Practice Address |
826 Washington St Suite 204 Watertown NY 13601-4064 |
| Practice Telephone | 3157881751 |
| Practice Fax Number | 3157889021 |
| Mailing Telephone | 3157881751 |
| Mailing Fax Number | 3157889021 |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRAXTON L HILLERMAN (PRESIDENT) |
| Authorized Official Telephone | 3157881751 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00458053 | 05 |
| Street Address |
826 WASHINGTON ST SUITE 204 |
| City | WATERTOWN |
| State | NY |
| Zip Code | 13601-4064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275529554 | Melissa A Charlebois | Physician Assistant | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2005-09-22 |
| 1487118840 | Brian Brown | Registered Nurse | 826 Washington St, Watertown, NY 13601-4063 | 2019-01-29 |
| 1457857013 | Foluso Bajowa | Nurse Anesthetist, Certified Registered | 826 Washington St, Watertown, NY 13601-4063 | 2018-04-03 |
| 1427496835 | John L Welborn Iv | Nurse Practitioner | 826 Washington St, Ste 106, Watertown, NY 13601-4063 | 2013-06-07 |
| 1366736480 | Heather Irobunda | Obstetrics & Gynecology | 826 Washington St, Watertown, NY 13601-4063 | 2011-06-06 |
| 1952635443 | Creative Optical, LLC | Technician/Technologist | 826 Washington St, Suite 100, Watertown, NY 13601-4063 | 2009-09-30 |
| 1881841674 | Eduardo B Barayuga | Surgery | 826 Washington St, Watertown, NY 13601-4063 | 2008-08-22 |
| 1609037555 | Christopher M Novak | Obstetrics & Gynecology | 826 Washington St, Suite 202, Watertown, NY 13601-4063 | 2008-06-23 |
| 1124202619 | Samaritan Medical Practice, PC | Surgery | 826 Washington St, Watertown, NY 13601-4063 | 2007-12-20 |
| 1386769560 | Jefferson Eye Surgeons, LLP | Ophthalmology | 826 Washington St, Suite 102, Watertown, NY 13601-4063 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801414156 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 122 Court Street, Empsall Bldg, Room 212, Watertown, NY 13601 | 2020-07-13 |
| 1083231377 | Katherine Anne Cahill | Counselor | 22679 Duffy Road, Watertown, NY 13601 | 2020-07-02 |
| 1851855431 | Hanna Kearney | Physical Therapist | 20053 Summit View Blvd Ste 2, Watertown, NY 13601 | 2019-01-28 |
| 1578039905 | North Country Counseling Services LLC | Counselor | 210 Court St. Suite 4, Watertown, NY 13601 | 2018-10-24 |
| 1073004388 | Megan Anna O'brien | Counselor | 221 S Rutland Street, Watertown, NY 13601 | 2018-05-22 |
| 1558860536 | Kimberly Lynne Amelio | Specialist | 24850 Hinds Rd, Watertown, NY 13601 | 2018-02-06 |
| 1952840050 | Alberto Gonzalez | Social Worker | 211 Jb Wise Plaza, Watertown, NY 13601 | 2017-02-22 |
| 1073967386 | Amanda Pisarski | Licensed Practical Nurse | 26713 Nys Rte 12, Watertown, NY 13601 | 2016-04-22 |
| 1396137709 | Daniel Ernest Morgan | Neuromusculoskeletal Medicine & OMM | 21101 Ny-12f, Building 2, Suite 7, Watertown, NY 13601 | 2015-02-21 |
| 1568868131 | Megan E. Zamora | Dental Hygienist | 14652-b Cedar Way, Watertown, NY 13601 | 2014-11-10 |
| Find all providers in zip 13601 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851822076 | Fort Health Care Inc | Otolaryngology | 123 Hospital Dr Suite 106a, Watertown, WI 53098 | 2017-03-21 |
| 1194072660 | Watertown Regional Medical Center, Inc | Otolaryngology | 123 Hospital Dr, Ste 2002, Watertown, WI 53098-3320 | 2012-08-14 |
| 1811006786 | Albert A. Mcclain Jr. | Otolaryngology | 830 Washington St, Watertown, NY 13601-4034 | 2006-08-30 |
| 1972525962 | Sanford Clinic | Otolaryngology | 600 4th St Ne, Suite 101, Watertown, SD 57201-1898 | 2006-07-25 |
| 1033147772 | Norman Weir | Otolaryngology | 826 Washington St, Watertown, NY 13601-4063 | 2006-06-29 |
| 1790736890 | Tony C.y. Chuang | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2006-05-13 |
| 1932177862 | Central Otologic Ltd | Otolaryngology | 123 Hospital Drive, Ste 106, Watertown, WI 53098 | 2006-03-08 |
| 1033105309 | Braxton L Hillerman | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2005-09-22 |
| 1144216359 | William I Forbes IIi | Otolaryngology | 826 Washington St, Suite 204, Watertown, NY 13601-4063 | 2005-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235766361 | Ali Agarabi | Otolaryngology | 675 Westview Dr, Mattituck, NY 11952-2963 | 2020-03-26 |
| 1932739281 | Ear Nose & Throat Medical Services of New York, Pllc | Otolaryngology | 8 Quaker Ridge Rd, Glen Head, NY 11545-3326 | 2020-01-24 |
| 1669002283 | Robert I Kaplan Md Pllc | Otolaryngology | 1524 Route 9 Ste 2, Halfmoon, NY 12065-8646 | 2020-01-23 |
| 1154965648 | B Thuy Le Md P C | Otolaryngology | 589 Broadway Fl 2, New York, NY 10012-3231 | 2019-10-29 |
| 1659938959 | Tony Richa | Otolaryngology | Elm and Carlton Streets Head and Neck Surgical Oncology, Buffalo, NY 14263-0001 | 2019-05-22 |
| 1003372632 | Nancy King Md Pllc | Otolaryngology | 128 Mott St Ste 608, New York, NY 10013-5589 | 2019-02-19 |
| 1265919179 | Rian Rosen | Otolaryngology | 420 Madison Ave Rm 503, New York, NY 10017-1175 | 2018-07-24 |
| 1225514409 | Mauricio R. Milhoua | Otolaryngology | 16 Marion Place, South Huntington, NY 11746 | 2018-07-11 |
| 1003308172 | Greater Buffalo Ent | Otolaryngology | 3950 E Robinson Rd Ste 106, Amherst, NY 14228-2042 | 2018-06-04 |
| 1184141798 | Ofer Azoulay | Otolaryngology | 185 Montague St Fl 5, Brooklyn, NY 11201-3608 | 2017-08-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.