Healthcare Provider Details

I. General information

NPI: 1639878713
Provider Name (Legal Business Name): EXCEL ANESTHESIA ASSOCIATES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2023
Last Update Date: 07/04/2023
Certification Date: 07/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 ALLIED DR
DEDHAM MA
02026-6146
US

IV. Provider business mailing address

PO BOX 95000 - 8622
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 617-865-1110
  • Fax: 617-830-9339
Mailing address:
  • Phone: 888-851-4642
  • Fax: 617-830-9339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ALFRED L DANIELS
Title or Position: PRESIDENT
Credential: MD
Phone: 617-865-1110