Provider Demographics
NPI:1518198951
Name:ADVANCED ANESTHESIA SPECIALISTS, PC
Entity Type:Organization
Organization Name:ADVANCED ANESTHESIA SPECIALISTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZONSHAYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-969-2331
Mailing Address - Street 1:12000 BUSTLETON AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-2151
Mailing Address - Country:US
Mailing Address - Phone:215-969-2331
Mailing Address - Fax:215-969-2334
Practice Address - Street 1:12000 BUSTLETON AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-2151
Practice Address - Country:US
Practice Address - Phone:215-969-2331
Practice Address - Fax:215-969-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD054720L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
169572Medicare PIN