Healthcare Provider Details

I. General information

NPI: 1831436435
Provider Name (Legal Business Name): ANESTHESIA CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 01/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 PLANDOME ROAD
MANHASSET NY
11030
US

IV. Provider business mailing address

565 PLANDOME ROAD
MANHASSET NY
11030
US

V. Phone/Fax

Practice location:
  • Phone: 212-679-0009
  • Fax: 212-629-0054
Mailing address:
  • Phone: 212-679-0009
  • Fax: 212-629-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. REUBEN W. IBARRETA
Title or Position: BILLING SUPERVISOR
Credential:
Phone: 212-679-0009