Healthcare Provider Details
I. General information
NPI: 1821046749
Provider Name (Legal Business Name): JAMESTOWN ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
207 FOOTE AVENUE
JAMESTOWN NY
14702
US
IV. Provider business mailing address
202 TAUGHANNOCK BLVD. PO BOX 366
ITHACA NY
14851
US
V. Phone/Fax
- Phone: 716-487-0141
- Fax:
- Phone: 607-277-3257
- Fax: 607-277-4056
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NADIA
F
GELEIL
Title or Position: MD
Credential: MD
Phone: 716-484-1111