Healthcare Provider Details
I. General information
NPI: 1134529035
Provider Name (Legal Business Name): STRATEGY ANESTHESIA NEW YORK PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/27/2014
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4902 QUEENS BLVD
WOODSIDE NY
11377-4444
US
IV. Provider business mailing address
19644 CLUB HOUSE RD
MONTGOMERY VILLAGE MD
20886-3047
US
V. Phone/Fax
- Phone: 718-784-4502
- Fax: 718-784-5180
- Phone: 703-665-3046
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KASHIF
IRFAN
Title or Position: OWNER
Credential: M.D.
Phone: 703-665-3046