Basic Information
| Provider Information | |||||||||
| NPI: | 1124367743 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOMERS ANESTHESIOLOGY ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99 EAST RIVER DR. | ||||||||
| Address2: | SOMERS ANESTHESIOLOGY ASSOCIATES | ||||||||
| City: | EAST HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061087301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8602824133 | ||||||||
| FaxNumber: | 8602890742 | ||||||||
| Practice Location | |||||||||
| Address1: | 201 CHESTNUT HILL RD | ||||||||
| Address2: | |||||||||
| City: | STAFFORD SPRINGS | ||||||||
| State: | CT | ||||||||
| PostalCode: | 060769925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8606848424 | ||||||||
| FaxNumber: | 8606848460 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2013 | ||||||||
| LastUpdateDate: | 02/01/2013 | ||||||||
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| AuthorizedOfficialLastName: | BRAKONICEKI | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8606848424 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.