Basic Information
| Provider Information | |||||||||
| NPI: | 1588175756 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW YORK ANESTHESIA SPECIALISTS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 270 | ||||||||
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| City: | MASSAPEQUA PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117620270 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6312642030 | ||||||||
| FaxNumber: | 6312641418 | ||||||||
| Practice Location | |||||||||
| Address1: | 1041 3RD AVE | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100658114 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125107802 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2017 | ||||||||
| LastUpdateDate: | 03/23/2018 | ||||||||
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| AuthorizedOfficialLastName: | KURTIS | ||||||||
| AuthorizedOfficialFirstName: | NOAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2125107802 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.