Provider Demographics
NPI:1962444505
Name:NIAGARA FRONTIER ANESTHESIA SERVICES LLP
Entity Type:Organization
Organization Name:NIAGARA FRONTIER ANESTHESIA SERVICES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCHUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:716-674-8189
Mailing Address - Street 1:4185 SENECA ST
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3565
Mailing Address - Country:US
Mailing Address - Phone:716-674-8189
Mailing Address - Fax:
Practice Address - Street 1:4185 SENECA ST
Practice Address - Street 2:SUITE 11
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-3565
Practice Address - Country:US
Practice Address - Phone:716-674-8189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335615367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000565077002OtherBLUE CROSS BLUE SHIELD
NY430047745OtherRAILROAD MEDICARE
NYBB3302Medicare ID - Type Unspecified