Basic Information
| Provider Information | |||||||||
| NPI: | 1346234044 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES IN ANESTHESIOLOGY, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3622 BELMONT AVE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445051450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307599350 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3622 BELMONT AVE | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | YOUNGSTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445051450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3307599350 | ||||||||
| FaxNumber: | 3307599387 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MOHAPATRA | ||||||||
| AuthorizedOfficialFirstName: | BASANTA | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3307599350 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 0294757 | 05 | OH | MEDICAID |