MEDICARE: FIFTH AVENUE ANESTHESIA ASSOCIATES, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1033115415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIFTH AVENUE ANESTHESIA ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	PO BOX 26940
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-6940
Country	:	US
Telephone Number	:	201-804-2800
Fax Number	:

Provider Business Practice Location Address
First Line	:	1049 5TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0115
Country	:	US
Telephone Number	:	212-772-6667
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSEPH JAY TERRASI
Credential	:	M.D.
Telephone Number	:	212-772-6667

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	08/22/2020

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