Provider Demographics
NPI:1083719074
Name:ANESTHESIOLOGY ASSOCIATES, PC
Entity Type:Organization
Organization Name:ANESTHESIOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOCHENEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:765-447-5329
Mailing Address - Street 1:712 N EARL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-2715
Mailing Address - Country:US
Mailing Address - Phone:765-447-5329
Mailing Address - Fax:765-448-4368
Practice Address - Street 1:712 N EARL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2715
Practice Address - Country:US
Practice Address - Phone:765-447-5329
Practice Address - Fax:765-448-4368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN807660Medicare ID - Type Unspecified