Healthcare Provider Details

I. General information

NPI: 1629074224
Provider Name (Legal Business Name): ANESTHESIA CARE GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MCGREGOR ST SUITE 303
MANCHESTER NH
03102-3750
US

IV. Provider business mailing address

1305 WALT WHITMAN RD STE 300
MELVILLE NY
11747-4300
US

V. Phone/Fax

Practice location:
  • Phone: 315-413-5229
  • Fax: 603-647-2453
Mailing address:
  • Phone: 516-945-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER ZIELINSKI
Title or Position: SENIOR CREDENTIALING SPECIALIST
Credential:
Phone: 516-945-3028