Provider Demographics
NPI:1649967415
Name:MEDICAL ANESTHESIOLOGY PC
Entity type:Organization
Organization Name:MEDICAL ANESTHESIOLOGY PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CODER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:631-220-3994
Mailing Address - Street 1:PO BOX 220059
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11022-0059
Mailing Address - Country:US
Mailing Address - Phone:631-220-3994
Mailing Address - Fax:516-307-3396
Practice Address - Street 1:3 MERITORIA DR
Practice Address - Street 2:
Practice Address - City:EAST WILLISTON
Practice Address - State:NY
Practice Address - Zip Code:11596-2037
Practice Address - Country:US
Practice Address - Phone:631-220-3994
Practice Address - Fax:516-307-3396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty