Provider Demographics
NPI:1437111879
Name:NORTHEAST ANESTHESIA PARTNERS, INC.
Entity Type:Organization
Organization Name:NORTHEAST ANESTHESIA PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATILLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-338-1660
Mailing Address - Street 1:601 WASHINGTON AVE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-1986
Mailing Address - Country:US
Mailing Address - Phone:859-291-4800
Mailing Address - Fax:859-655-8588
Practice Address - Street 1:11518 TILLBURY CV
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-2138
Practice Address - Country:US
Practice Address - Phone:260-338-1660
Practice Address - Fax:260-338-1659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200810870AMedicaid
IN200810870AMedicaid
DE6459Medicare PIN
IN200810870AMedicaid