Provider Demographics
NPI:1760468698
Name:PARK SLOPE ANESTHESIA ASSOCIATES PC
Entity Type:Organization
Organization Name:PARK SLOPE ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIANODICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-780-3000
Mailing Address - Street 1:2 CATHARINE ST
Mailing Address - Street 2:P O BOX 550
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3100
Mailing Address - Country:US
Mailing Address - Phone:866-868-8416
Mailing Address - Fax:845-790-2675
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:NY METHODIST HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3000
Practice Address - Fax:845-790-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02151568Medicaid
NY02151568Medicaid