Healthcare Provider Details

I. General information

NPI: 1689085250
Provider Name (Legal Business Name): WARWICK ANESTHESIA GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 MAPLE AVE
WARWICK NY
10990-1028
US

IV. Provider business mailing address

PO BOX 875
WARWICK NY
10990-0875
US

V. Phone/Fax

Practice location:
  • Phone: 845-986-2224
  • Fax:
Mailing address:
  • Phone: 845-294-2006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CHING HUANG HUANG
Title or Position: OWNER/DIRECTOR
Credential: MD
Phone: 908-653-9399