Provider Demographics
NPI:1649598145
Name:RESOURCE ANESTHESIOLOGY ASSOCIATES OF ME, PC
Entity Type:Organization
Organization Name:RESOURCE ANESTHESIOLOGY ASSOCIATES OF ME, PC
Other - Org Name:NORTHERN MAINE AMBLUTORY ENDOSCOPY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:KOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-637-3511
Mailing Address - Street 1:10 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5214
Mailing Address - Country:US
Mailing Address - Phone:914-637-3530
Mailing Address - Fax:914-637-3535
Practice Address - Street 1:11 MARTIN ST
Practice Address - Street 2:
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769-2238
Practice Address - Country:US
Practice Address - Phone:207-764-0679
Practice Address - Fax:207-764-1569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-07
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty