Provider Demographics
NPI:1093390650
Name:AKPAN RAYMOND ANESTHESIA LLC
Entity Type:Organization
Organization Name:AKPAN RAYMOND ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPAN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:401-617-2349
Mailing Address - Street 1:50 MILL ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5653
Mailing Address - Country:US
Mailing Address - Phone:401-617-2349
Mailing Address - Fax:
Practice Address - Street 1:50 MILL ST UNIT B
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5653
Practice Address - Country:US
Practice Address - Phone:401-617-2349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty