Healthcare Provider Details

I. General information

NPI: 1073571485
Provider Name (Legal Business Name): TRI COUNTY ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 03/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 MASONS MILL RD SUITE 501
HUNTINGDON VALLEY PA
19006-3517
US

IV. Provider business mailing address

3501 MASONS MILL RD SUITE 501
HUNTINGDON VALLEY PA
19006-3517
US

V. Phone/Fax

Practice location:
  • Phone: 215-830-0530
  • Fax: 215-830-0542
Mailing address:
  • Phone: 215-830-0530
  • Fax: 215-830-0542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAY M MERGAMAN
Title or Position: CEO
Credential: M.D.
Phone: 215-773-9514