Provider Demographics
NPI:1184645194
Name:COMMONWEALTH ANESTHESIA ASSOCIATES, INC
Entity Type:Organization
Organization Name:COMMONWEALTH ANESTHESIA ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE CHAIR ANESTHESIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:617-243-6298
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:NEWTON WELLESLEY HOSPITAL DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-243-6298
Mailing Address - Fax:617-243-6184
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:NEWTON WELLESLEY HOSPITAL DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6298
Practice Address - Fax:617-243-6184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9763406Medicaid
MA9763406Medicaid