Provider Demographics
NPI:1508947441
Name:YORK ANESTHESIOLOGISTS PLLC
Entity Type:Organization
Organization Name:YORK ANESTHESIOLOGISTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF ANESTHESIA
Authorized Official - Prefix:
Authorized Official - First Name:SUNDARARAO
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPPOLU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-420-2385
Mailing Address - Street 1:PO BOX 270
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11762-0270
Mailing Address - Country:US
Mailing Address - Phone:631-264-2035
Mailing Address - Fax:631-264-1418
Practice Address - Street 1:1ST AVENUE AT 16TH ST
Practice Address - Street 2:BETH ISRAEL MEDICAL CENTER/PETRIE DIVISION
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty