Healthcare Provider Details

I. General information

NPI: 1285630319
Provider Name (Legal Business Name): LAUREL ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 01/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AESTHETIC WAY
GREENSBURG PA
15601-9500
US

IV. Provider business mailing address

PO BOX 595
LIGONIER PA
15658-0595
US

V. Phone/Fax

Practice location:
  • Phone: 724-832-7555
  • Fax:
Mailing address:
  • Phone: 201-804-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DAVID W. BEYER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 724-552-0068