Provider Demographics
NPI:1285684373
Name:ASSOCIATED ANESTHESIOLOGISTS OF THE FINGER LAKES, L.L.P.
Entity Type:Organization
Organization Name:ASSOCIATED ANESTHESIOLOGISTS OF THE FINGER LAKES, L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-737-4100
Mailing Address - Street 1:PO BOX 1253
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901
Mailing Address - Country:US
Mailing Address - Phone:607-737-3639
Mailing Address - Fax:607-737-1292
Practice Address - Street 1:600 ROE AVENUE
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14905
Practice Address - Country:US
Practice Address - Phone:607-737-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01586612Medicaid
NY55779AMedicare PIN