Basic Information
| Provider Information | |||||||||
| NPI: | 1861446478 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DELAWARE VALLEY ANESTHESIA ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 N OXFORD VALLEY RD | ||||||||
| Address2: | SUITE 510 | ||||||||
| City: | FAIRLESS HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190302624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159493100 | ||||||||
| FaxNumber: | 2159498521 | ||||||||
| Practice Location | |||||||||
| Address1: | 333 N OXFORD VALLEY RD | ||||||||
| Address2: | SUITE 510 | ||||||||
| City: | FAIRLESS HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190302624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2159493100 | ||||||||
| FaxNumber: | 2159498521 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2006 | ||||||||
| LastUpdateDate: | 06/21/2018 | ||||||||
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| AuthorizedOfficialLastName: | RIZZO | ||||||||
| AuthorizedOfficialFirstName: | RIZZO | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2157850145 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 1171914 | 01 | NJ | AETNA NJ | OTHER | 33029 | 01 | PA | HORIZON MERCY | OTHER | 50001823 | 01 | PA | CAPITAL BLUE CROSS | OTHER | CA5687 | 01 | PA | RAILROAD MEDICARE | OTHER | 0022351000 | 01 | PA | KHPE | OTHER | 0004347 | 01 | PA | AETNA HMO | OTHER | 172813 | 01 | PA | BLUE CHOICE | OTHER | 33028 | 01 | PA | KEYSTONE MERCY | OTHER | 3Y2278 | 01 | PW | HEALTH NET | OTHER | DA7311 | 01 | NJ | RAILROAD MEDICARE | OTHER | 0022351000 | 01 | PA | AMERIHEALTH MERCY | OTHER | 172813 | 01 | PA | PERSONAL CHOICE | OTHER | 172813 | 01 | PA | PA BLUE SHIELD | OTHER | A645008 | 01 | PA | OXFORD | OTHER | DB0245 | 01 | PA | RAILROAD MEDICARE | OTHER |