Healthcare Provider Details

I. General information

NPI: 1548209331
Provider Name (Legal Business Name): CENTRAL MASS ANESTHESIA AFFILIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 BELMONT ST
WORCESTER MA
01605-2903
US

IV. Provider business mailing address

119 BELMONT ST
WORCESTER MA
01605-2903
US

V. Phone/Fax

Practice location:
  • Phone: 508-334-6491
  • Fax:
Mailing address:
  • Phone: 508-334-6491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMA

VIII. Authorized Official

Name: BARBARA ANUSAUSKAS
Title or Position: OFFICE MANAGER
Credential:
Phone: 508-334-6491