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General NPI Number Information
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NPI Number | 1013106111
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Entity Type | Organization
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Legal Business Name | ANESTHESIA ASSOCIATES
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 99 E STATE ST
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1203
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Country | US
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Telephone | 518-775-4208
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Fax | 518-775-4271
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Provider Business Mailing Address
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Address Line | 99 E STATE ST
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1203
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Country | US
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Telephone | 518-775-4208
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Fax | 518-775-4271
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Authorized Official
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Title or Position | CHIEF OF GROUP
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Name | HESARAGHATTA KESHAVA
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Credential | MD
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Telephone | 518-775-4208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 119483-1
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License Number State | NY
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