Provider Demographics
NPI:1609926971
Name:ROXBURY ANESTHESIA, LLC
Entity Type:Organization
Organization Name:ROXBURY ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ATHANASIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:SCINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-989-8464
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-0035
Mailing Address - Country:US
Mailing Address - Phone:412-937-5700
Mailing Address - Fax:770-666-9078
Practice Address - Street 1:550 NEWARK AVE
Practice Address - Street 2:5TH FLOOR
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-0550
Practice Address - Country:US
Practice Address - Phone:201-795-0205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ111133Medicare PIN