Healthcare Provider Details

I. General information

NPI: 1881950368
Provider Name (Legal Business Name): QUALITY ANESTHESIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2012
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4979 OLD STREET RD SURGERY CENTER
TREVOSE PA
19053-6222
US

IV. Provider business mailing address

PO BOX 670
FEASTERVILLE TREVOSE PA
19053-0670
US

V. Phone/Fax

Practice location:
  • Phone: 267-684-6065
  • Fax: 215-933-3120
Mailing address:
  • Phone: 267-684-6065
  • Fax: 215-933-3120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD A SIVICK JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 215-651-8180