DR. EKRAM JOHN BOULOS (NPI# 1639278310) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639278310 |
| Entity Type | Individual |
| Full Name | DR. EKRAM JOHN BOULOS |
| Credential | MD |
| Practice Address |
11075 West Center Street Extension Medina NY 14103 |
| Mailing Address |
11075 W Center St Ext Po Box 487 Medina NY 14103 |
| Practice Telephone | 5857981053 |
| Practice Fax Number | 5857985639 |
| Mailing Telephone | 5857981053 |
| Mailing Fax Number | 5857985639 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2010-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 141441 | NY | Allopathic & Osteopathic Physicians |
| N | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
141441 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00642420 | 05 |
| Street Address |
11075 WEST CENTER STREET EXTENSION |
| City | MEDINA |
| State | NY |
| Zip Code | 14103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063772473 | Melody Ann Parker | Licensed Practical Nurse | 1026 Park Avenue, Medina, NY 14103 | 2012-05-18 |
| 1720253883 | Gary L Condoluci | Massage Therapist | 11020 West Center St Ext, Medina, NY 14103 | 2008-04-29 |
| 1437280955 | Orleans Community Health | Clinic/Center | 11020 West Center Street Ext., Medina, NY 14103 | 2007-03-08 |
| 1902933328 | Sallah U Abbasey | Homeopath | 3662 Culvert Road, Medina, NY 14103 | 2007-02-27 |
| 1548395429 | Salvatore Russell Pecoraro | Emergency Medicine | 200 Ohio Street, Medina Memorial Hospital, Medina, NY 14103 | 2007-02-22 |
| 1285783704 | Medina Central School District | Local Education Agency (LEA) | One Mustang Drive, Medina, NY 14103 | 2007-01-10 |
| 1598771289 | Katherine Price | Midwife | 100 Ohio Street, Medina, NY 14103 | 2006-08-01 |
| 1831156967 | Nadia Alexandra Nava | Physical Therapist | 711 Park Ave, Medina, NY 14103 | 2006-05-01 |
| 1336104090 | Amy Sue Herman | Pharmacist | 526 Main Street, Rosenkrans Pharmacy, Medina, NY 14103 | 2006-04-18 |
| 1124097878 | Arthur W Mruczek Sr. | Ophthalmology | 500 Erie Street South, Lake Plains Eye Center, Medina, NY 14103 | 2006-03-15 |
| Find all providers in zip 14103 | ||||
| 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 |
|---|---|---|---|---|
| 1841291507 | Matthew C Mcdonnell | Otolaryngology | 970 East Washington Street, Suite 6a, Medina, OH 44256 | 2005-08-03 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.