Provider Demographics
NPI:1184172439
Name:CONCIERGE ANESTHESIA PRACTICE P.C.
Entity type:Organization
Organization Name:CONCIERGE ANESTHESIA PRACTICE P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAKSHILA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-726-3371
Mailing Address - Street 1:94 STANDISH RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1118
Mailing Address - Country:US
Mailing Address - Phone:781-449-9864
Mailing Address - Fax:844-557-3817
Practice Address - Street 1:94 STANDISH RD
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-1118
Practice Address - Country:US
Practice Address - Phone:781-449-9864
Practice Address - Fax:844-557-3817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76495207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3103927Medicaid
MA3103927Medicaid
J13048Medicare PIN