Healthcare Provider Details
I. General information
NPI: 1417793878
Provider Name (Legal Business Name): NORTH AMERICAN PARTNERS IN ANESTHESIA (ARIZONA), LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/05/2024
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6501 N 19TH AVE
PHOENIX AZ
85015-1646
US
IV. Provider business mailing address
1305 WALT WHITMAN RD STE 300
MELVILLE NY
11747-4300
US
V. Phone/Fax
- Phone: 516-945-3000
- Fax:
- Phone: 516-945-3000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MANOJ
SHAHANE
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 732-841-8533