Provider Demographics
NPI:1457057374
Name:MAINE ANESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:MAINE ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROON
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-621-6854
Mailing Address - Street 1:111 TOWN SQUARE PL STE 420
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-1724
Mailing Address - Country:US
Mailing Address - Phone:888-589-8550
Mailing Address - Fax:201-604-6571
Practice Address - Street 1:254 COMMERCIAL ST STE 245
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4899
Practice Address - Country:US
Practice Address - Phone:888-589-8550
Practice Address - Fax:201-604-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty