Basic Information
| Provider Information | |||||||||
| NPI: | 1427344373 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEDICAL ANCILLARY SERVICES, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 118 N BEDFORD RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105492553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146668866 | ||||||||
| FaxNumber: | 9146666777 | ||||||||
| Practice Location | |||||||||
| Address1: | 974 ROUTE 45 | ||||||||
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| City: | POMONA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109703520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453543700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/20/2011 | ||||||||
| LastUpdateDate: | 06/20/2011 | ||||||||
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| AuthorizedOfficialLastName: | HELLER | ||||||||
| AuthorizedOfficialFirstName: | ELLIOT | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8453543700 | ||||||||
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| 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 | 367500000X | NY | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | NY | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.