Healthcare Provider Details

I. General information

NPI: 1720226483
Provider Name (Legal Business Name): ALLIANCE ANESTHESIOLOGY ASSOCIATES, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 WESTCHESTER AVE SUITE 102
BRONX NY
10461-4500
US

IV. Provider business mailing address

P.O. BOX 5628
HICKSVILLE NY
11802-5628
US

V. Phone/Fax

Practice location:
  • Phone: 718-518-9000
  • Fax:
Mailing address:
  • Phone: 631-862-3540
  • Fax: 631-862-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN J. ROHAN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 631-862-3538