MEDICARE: NEW YORK MEDICAL ANESTHESIA

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1164250114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW YORK MEDICAL ANESTHESIA

Provider Business Mailing Address
First Line	:	133 E 58TH ST STE 402
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1157
Country	:	US
Telephone Number	:	646-883-6965
Fax Number	:	844-748-0838

Provider Business Practice Location Address
First Line	:	133 E 58TH ST STE 402
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1157
Country	:	US
Telephone Number	:	646-883-6965
Fax Number	:	844-748-0838

Authorized Official
Title or Position	:	BILLER
Name	:	MS. KAREN MATTHEWS
Credential	:
Telephone Number	:	773-322-6517

Provider Enumeration Date	:	07/22/2024
Last Update Date	:	07/25/2024

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Directions to “NEW YORK MEDICAL ANESTHESIA ” Practice Location

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