Provider Demographics
NPI:1770882052
Name:GAC ANESTHESIA LLC
Entity type:Organization
Organization Name:GAC ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:LISSAUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-593-7180
Mailing Address - Street 1:3700 PARK EAST DR
Mailing Address - Street 2:STE 100
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4339
Mailing Address - Country:US
Mailing Address - Phone:216-593-7180
Mailing Address - Fax:
Practice Address - Street 1:3700 PARK EAST DR
Practice Address - Street 2:STE 100
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4339
Practice Address - Country:US
Practice Address - Phone:216-593-7180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GASTROENTEROLOGY ASSOCIATES OF CLEVELAND, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-25
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty