Healthcare Provider Details

I. General information

NPI: 1942201264
Provider Name (Legal Business Name): SURGI-CENTER ANESTHESIOLOGISTS, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 11/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 ROBBINS ST
WATERBURY CT
06708-2652
US

IV. Provider business mailing address

99 EAST RIVER DR 5TH FL
EAST HARTFORD CT
06108-7301
US

V. Phone/Fax

Practice location:
  • Phone: 203-755-6663
  • Fax: 203-756-9645
Mailing address:
  • Phone: 860-282-4022
  • Fax: 860-289-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM TURLEY
Title or Position: PRESIDENT
Credential: MD
Phone: 203-755-6663