Basic Information
| Provider Information | |||||||||
| NPI: | 1720226483 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLIANCE ANESTHESIOLOGY ASSOCIATES, P.L.L.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 5628 | ||||||||
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| City: | HICKSVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118025628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6318623540 | ||||||||
| FaxNumber: | 6318623604 | ||||||||
| Practice Location | |||||||||
| Address1: | 3250 WESTCHESTER AVE | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104614500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185189000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2009 | ||||||||
| LastUpdateDate: | 11/20/2015 | ||||||||
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| AuthorizedOfficialLastName: | ROHAN | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | J. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 6318623538 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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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.