Provider Demographics
NPI:1033427844
Name:LANESTHA, P.C.
Entity Type:Organization
Organization Name:LANESTHA, P.C.
Other - Org Name:LANESTHA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-905-3537
Mailing Address - Street 1:2 PARK LN STE 101
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6004
Mailing Address - Country:US
Mailing Address - Phone:215-953-9944
Mailing Address - Fax:215-953-9943
Practice Address - Street 1:2 PARK LN STE 101
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6004
Practice Address - Country:US
Practice Address - Phone:215-953-9944
Practice Address - Fax:215-953-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 433567207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty