Provider Demographics
NPI:1851949945
Name:VITAL ANESTHESIA SERVICES
Entity Type:Organization
Organization Name:VITAL ANESTHESIA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAYSHTUT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-229-4926
Mailing Address - Street 1:244 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3001
Mailing Address - Country:US
Mailing Address - Phone:646-229-4926
Mailing Address - Fax:
Practice Address - Street 1:244 ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3001
Practice Address - Country:US
Practice Address - Phone:646-229-4926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-31
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty