Healthcare Provider Details

I. General information

NPI: 1740280544
Provider Name (Legal Business Name): AMBULATORY SURGERY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 STANLEY ST
FALL RIVER MA
02720-6009
US

IV. Provider business mailing address

340 MAIN ST STE 670
WORCESTER MA
01608-1604
US

V. Phone/Fax

Practice location:
  • Phone: 508-672-2290
  • Fax: 508-674-8419
Mailing address:
  • Phone: 508-754-3566
  • Fax: 508-798-8012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateMA

VIII. Authorized Official

Name: CYNTHIA A HINES
Title or Position: PRESIDENT
Credential: MD
Phone: 508-672-2290