Provider Demographics
NPI:1245400449
Name:TAPAS ANESTHESIA SERVICE LLC.
Entity Type:Organization
Organization Name:TAPAS ANESTHESIA SERVICE LLC.
Other - Org Name:TAPAS ANESTHESIA SERVICE LLC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ALBERT
Authorized Official - Last Name:PANNONE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:410-663-5852
Mailing Address - Street 1:2425 CUB HILL RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-1003
Mailing Address - Country:US
Mailing Address - Phone:410-663-5852
Mailing Address - Fax:
Practice Address - Street 1:2425 CUB HILL RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-1003
Practice Address - Country:US
Practice Address - Phone:410-663-5852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR053987163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0K085-TAOtherCARE FIRST BC/BS OF MD
MDOKO-85-TAOtherCARE FIRST BLUE CHOICE
MDOKO85-TAOtherNCAS