Healthcare Provider Details

I. General information

NPI: 1407560618
Provider Name (Legal Business Name): PULSE ANESTHESIA CONSULTANTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 05/30/2023
Certification Date: 05/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 WASON AVE FL 2
SPRINGFIELD MA
01107-1280
US

IV. Provider business mailing address

LB#8562 PO BOX 9500
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-1800
  • Fax:
Mailing address:
  • Phone: 888-851-4642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GHASSAN ALI A ALJAFAR
Title or Position: OWNER
Credential: MD
Phone: 413-794-1800