Healthcare Provider Details
I. General information
NPI: 1760409502
Provider Name (Legal Business Name): STERLING ANESTHESIA MANAGEMENT SERVICES OF NEW YORK
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17 LANSING ST
AUBURN NY
13021-1983
US
IV. Provider business mailing address
STERLING ANESTHESIA OF NEW YORK P.O. BOX 822339
PHILADELPHIA PA
19182-0001
US
V. Phone/Fax
- Phone: 866-716-2907
- Fax: 410-793-0809
- Phone: 866-716-2907
- Fax: 410-793-0809
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
TOLL
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 866-716-2907