Healthcare Provider Details
I. General information
NPI: 1578796504
Provider Name (Legal Business Name): WARWICK ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/25/2009
Last Update Date: 09/28/2011
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 15 MAPLE AVENUE
WARWICK NY
10990-0875
US
V. Phone/Fax
- Phone: 845-294-2006
- Fax: 845-615-1590
- Phone: 845-294-2006
- Fax: 845-615-1590
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MING
C
CHIOU
Title or Position: PRESIDENT
Credential: MD
Phone: 845-294-2006