Provider Demographics
NPI:1851459184
Name:NASSAU AMBULATORY ANESTHESIA ASSOCIATES PC
Entity Type:Organization
Organization Name:NASSAU AMBULATORY ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:BHARDWAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-280-8202
Mailing Address - Street 1:255 GLEN COVE RD
Mailing Address - Street 2:
Mailing Address - City:CARLE PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11514-1207
Mailing Address - Country:US
Mailing Address - Phone:516-280-8202
Mailing Address - Fax:516-280-8204
Practice Address - Street 1:255 GLEN COVE RD
Practice Address - Street 2:
Practice Address - City:CARLE PLACE
Practice Address - State:NY
Practice Address - Zip Code:11514-1207
Practice Address - Country:US
Practice Address - Phone:516-280-8202
Practice Address - Fax:516-280-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYW15431Medicare ID - Type Unspecified
C05814Medicare UPIN