Provider Demographics
NPI:1225267354
Name:EMPIRE AMBULATORY ANESTHESIA PLLC
Entity Type:Organization
Organization Name:EMPIRE AMBULATORY ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-428-5454
Mailing Address - Street 1:800 WESTCHESTER AVE
Mailing Address - Street 2:S614
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1354
Mailing Address - Country:US
Mailing Address - Phone:914-428-5454
Mailing Address - Fax:914-428-5460
Practice Address - Street 1:800 WESTCHESTER AVE
Practice Address - Street 2:S614
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-1354
Practice Address - Country:US
Practice Address - Phone:914-428-5454
Practice Address - Fax:914-428-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty