Provider Demographics
NPI:1700939063
Name:ANESTHESIA ASSOCIATES OF NEW HAVEN PC
Entity Type:Organization
Organization Name:ANESTHESIA ASSOCIATES OF NEW HAVEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-865-3852
Mailing Address - Street 1:1423 CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-4411
Mailing Address - Country:US
Mailing Address - Phone:203-865-3852
Mailing Address - Fax:203-865-2983
Practice Address - Street 1:1423 CHAPEL ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-4411
Practice Address - Country:US
Practice Address - Phone:203-865-3852
Practice Address - Fax:203-865-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCC0217Medicare ID - Type UnspecifiedRAILROAD MEDICARE
CTC00476Medicare ID - Type UnspecifiedCT MEDICARE