Provider Demographics
NPI:1760434690
Name:ORANGE ANESTHESIA SERVICES P.C..
Entity Type:Organization
Organization Name:ORANGE ANESTHESIA SERVICES P.C..
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:845-343-6216
Mailing Address - Street 1:PO BOX 3118
Mailing Address - Street 2:682 E. MAIN ST
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-0810
Mailing Address - Country:US
Mailing Address - Phone:845-343-6216
Mailing Address - Fax:845-343-6228
Practice Address - Street 1:682 E MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2646
Practice Address - Country:US
Practice Address - Phone:845-343-6216
Practice Address - Fax:845-343-6228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW80121Medicare ID - Type Unspecified