Provider Demographics
NPI:1407236110
Name:ULTRACARE ANESTHESIA PARTNERS LLC
Entity Type:Organization
Organization Name:ULTRACARE ANESTHESIA PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BLANCK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:856-207-4900
Mailing Address - Street 1:7 N CHRISTOPHER COLUMBUS BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1422
Mailing Address - Country:US
Mailing Address - Phone:844-448-5872
Mailing Address - Fax:267-639-2281
Practice Address - Street 1:7 N CHRISTOPHER COLUMBUS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-1422
Practice Address - Country:US
Practice Address - Phone:844-448-5872
Practice Address - Fax:267-639-2281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty