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NPI Code Detail

MEDICARE: SOUTHERN NEW ENGLAND ANESTHESIA CONSULTANTS, LLC

MEDICARE: SOUTHERN NEW ENGLAND ANESTHESIA CONSULTANTS, LLC
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
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164427670
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN NEW ENGLAND ANESTHESIA CONSULTANTS, LLC
Provider Business Mailing Address
First Line : PO BOX 6208
Second Line :
City : PROVIDENCE
State : RI
Zip : 02940-6208
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 211 PARK ST
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-3143
Country : US
Telephone Number : 508-222-5200
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : SUSAN B POLLAN
Credential : M.D.
Telephone Number : 508-222-5200
Provider Enumeration Date : 06/21/2005
Last Update Date : 08/22/2020

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Directions to “SOUTHERN NEW ENGLAND ANESTHESIA CONSULTANTS, LLC ” Practice Location

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