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General NPI Number Information
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NPI Number | 1073897385
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Entity Type | Organization
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Legal Business Name | SO WESTCHESTER ANESTHESIA PC
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 62 PIETRO DR
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City | YONKERS
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State | NY
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Zip | 10710-2010
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Country | US
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Telephone | 914-319-3135
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Fax | 631-415-1334
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Provider Business Mailing Address
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Address Line | 62 PIETRO DR
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City | YONKERS
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State | NY
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Zip | 10710-2010
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Country | US
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Telephone | 914-319-3135
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Fax | 631-415-1334
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEONA Y PAN
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Credential | M.D.
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Telephone | 914-319-3135
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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 | 224543
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License Number State | NY
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