Healthcare Provider Details

I. General information

NPI: 1124073952
Provider Name (Legal Business Name): ANESTHESIA ASSOCIATES OF MOUNT KISCO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E MAIN ST ANES ASSOC OF MOUNT KISCO
MOUNT KISCO NY
10549-3417
US

IV. Provider business mailing address

PO BOX 27391
NEW YORK NY
10087-7391
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-4050
  • Fax: 914-666-5012
Mailing address:
  • Phone: 800-720-1664
  • Fax: 207-753-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: VICTOR VERMA
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 914-666-4050