Healthcare Provider Details

I. General information

NPI: 1497763213
Provider Name (Legal Business Name): CAP ANESTHESIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 09/30/2021
Certification Date: 09/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 SUNSET RD
WESTON MA
02493-1636
US

IV. Provider business mailing address

PO BOX 3636
BOSTON MA
02241-3636
US

V. Phone/Fax

Practice location:
  • Phone: 781-710-9857
  • Fax: 413-796-7498
Mailing address:
  • Phone: 781-407-7713
  • Fax: 781-407-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateMA

VIII. Authorized Official

Name: GARY ROBELEN
Title or Position: PRESIDENT
Credential:
Phone: 617-789-2782