Provider Demographics
NPI:1467699918
Name:LAWRENCE ANESTHESIA SERVICES, LLC
Entity Type:Organization
Organization Name:LAWRENCE ANESTHESIA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-623-2000
Mailing Address - Street 1:7111 FAIRWAY DRIVE
Mailing Address - Street 2:SUITE 450
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-4200
Mailing Address - Country:US
Mailing Address - Phone:561-623-2000
Mailing Address - Fax:201-804-8883
Practice Address - Street 1:1 GENERAL STREET
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01842-0389
Practice Address - Country:US
Practice Address - Phone:948-683-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084292AMedicaid
MA0009740Medicare PIN