Healthcare Provider Details

I. General information

NPI: 1801885231
Provider Name (Legal Business Name): WESTCHESTER ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 10/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 WESTCHESTER AVE
WHITE PLAINS NY
10604
US

IV. Provider business mailing address

PO BOX 1510
GERMANTOWN MD
20875-1510
US

V. Phone/Fax

Practice location:
  • Phone: 301-515-4222
  • Fax: 301-515-4153
Mailing address:
  • Phone: 301-515-4222
  • Fax: 301-515-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. LEWIE G ANDERSON
Title or Position: VICE PRESIDENT
Credential:
Phone: 301-515-4222