Provider Demographics
NPI:1720018989
Name:MAC ANESTHESIA, PC
Entity Type:Organization
Organization Name:MAC ANESTHESIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-749-5600
Mailing Address - Street 1:19617 HILLSIDE AVE
Mailing Address - Street 2:FF
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-2157
Mailing Address - Country:US
Mailing Address - Phone:718-749-5600
Mailing Address - Fax:
Practice Address - Street 1:19617 HILLSIDE AVE
Practice Address - Street 2:FF
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-2157
Practice Address - Country:US
Practice Address - Phone:718-749-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2011-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY198884207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEU501Medicare ID - Type Unspecified
G18066Medicare UPIN