Provider Demographics
NPI:1033242235
Name:SOUTHEAST ANESTHESIOLOGY CONSULTANTS OF VIRGINIA, PLLC
Entity Type:Organization
Organization Name:SOUTHEAST ANESTHESIOLOGY CONSULTANTS OF VIRGINIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAVIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ASCARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-289-4937
Mailing Address - Street 1:1305 WALT WHITMAN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:814 KEMPSVILLE RD.
Practice Address - Street 2:SUITE 104
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4602
Practice Address - Country:US
Practice Address - Phone:757-455-8887
Practice Address - Fax:757-461-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VADO6022OtherRAILROAD-MEDICARE
VAGC1190Medicare PIN