Provider Demographics
NPI:1881817377
Name:HARRIS ANESTHESIA ASSOCIATES PC
Entity Type:Organization
Organization Name:HARRIS ANESTHESIA ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HUSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-794-3300
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:HARRIS
Mailing Address - State:NY
Mailing Address - Zip Code:12742-0284
Mailing Address - Country:US
Mailing Address - Phone:845-794-3300
Mailing Address - Fax:845-791-7416
Practice Address - Street 1:39 OLD MONTICELLO RD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:NY
Practice Address - Zip Code:12734-5224
Practice Address - Country:US
Practice Address - Phone:845-292-0078
Practice Address - Fax:845-292-3244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01624684Medicaid
NYW08911Medicare ID - Type Unspecified