Provider Demographics
NPI:1093822132
Name:FAIRFIELD ANESTHESIA ASSOCIATES LLC
Entity Type:Organization
Organization Name:FAIRFIELD ANESTHESIA ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-374-1515
Mailing Address - Street 1:PO BOX 26899
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-6899
Mailing Address - Country:US
Mailing Address - Phone:203-374-1515
Mailing Address - Fax:
Practice Address - Street 1:112 QUARRY RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4848
Practice Address - Country:US
Practice Address - Phone:203-374-1515
Practice Address - Fax:203-374-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004101010Medicaid
CT004101010Medicaid