Provider Demographics
NPI:1134584949
Name:PHIL ANESTHESIA P.C.
Entity type:Organization
Organization Name:PHIL ANESTHESIA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-339-7500
Mailing Address - Street 1:851 SAINT MARKS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-1539
Mailing Address - Country:US
Mailing Address - Phone:718-339-7500
Mailing Address - Fax:
Practice Address - Street 1:851 SAINT MARKS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-1539
Practice Address - Country:US
Practice Address - Phone:718-339-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty