Provider Demographics
NPI:1780810150
Name:NY SURGICAL & ANESTHESIA SUITES PC
Entity type:Organization
Organization Name:NY SURGICAL & ANESTHESIA SUITES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAFTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-886-8215
Mailing Address - Street 1:3620 E TREMONT AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2038
Mailing Address - Country:US
Mailing Address - Phone:718-792-4878
Mailing Address - Fax:
Practice Address - Street 1:3620 E TREMONT AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2038
Practice Address - Country:US
Practice Address - Phone:718-792-4878
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203113261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical