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NPI Code Detail

MEDICARE: FINGER LAKES ANESTHESIA GROUP PC

MEDICARE: FINGER LAKES ANESTHESIA GROUP 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
1367500000XCertified Registered Nurse Anesthetist
2207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1972595908
Entity Type Code : Organization
Provider Name (Legal Business Name) : FINGER LAKES ANESTHESIA GROUP PC
Provider Business Mailing Address
First Line : PO BOX 2005
Second Line :
City : EAST SYRACUSE
State : NY
Zip : 13057-4505
Country : US
Telephone Number : 315-449-0513
Fax Number : 315-445-2936
Provider Business Practice Location Address
First Line : 555 E MARKET ST
Second Line :
City : ELMIRA
State : NY
Zip : 14901-3223
Country : US
Telephone Number : 607-733-6541
Fax Number : 607-737-1514
Authorized Official
Title or Position : PRESIDENT
Name : KAREN REED
Credential : MD
Telephone Number : 607-737-7831
Provider Enumeration Date : 08/16/2005
Last Update Date : 01/28/2008

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