Healthcare Provider Details

I. General information

NPI: 1447536446
Provider Name (Legal Business Name): CHELSEA ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2011
Last Update Date: 10/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 UNIVERSITY PL 8TH FLOOR
NEW YORK NY
10003-4515
US

IV. Provider business mailing address

95 UNIVERSITY PL 8TH FLOOR
NEW YORK NY
10003-4515
US

V. Phone/Fax

Practice location:
  • Phone: 917-371-9797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. REEM SHOUKRY
Title or Position: OFFICE MANAGER
Credential:
Phone: 917-371-9797