Provider Demographics
NPI:1083223887
Name:GENERAL ANESTHESIA MEDICAL SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:GENERAL ANESTHESIA MEDICAL SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-967-0677
Mailing Address - Street 1:100 CROSSWAYS PARK DR W STE 206A
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2012
Mailing Address - Country:US
Mailing Address - Phone:516-967-0677
Mailing Address - Fax:516-636-0047
Practice Address - Street 1:100 CROSSWAYS PARK DR W STE 206A
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2012
Practice Address - Country:US
Practice Address - Phone:516-967-0677
Practice Address - Fax:516-636-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty