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General NPI Number Information
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NPI Number | 1083223887
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Entity Type | Organization
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Legal Business Name | GENERAL ANESTHESIA MEDICAL SPECIALISTS, PLLC
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/28/2020
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Provider Practice Location Address
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Address Line | 100 CROSSWAYS PARK DR W STE 206A
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City | WOODBURY
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State | NY
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Zip | 11797-2012
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Country | US
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Telephone | 516-967-0677
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Fax | 516-636-0047
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Provider Business Mailing Address
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Address Line | 100 CROSSWAYS PARK DR W STE 206A
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City | WOODBURY
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State | NY
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Zip | 11797-2012
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Country | US
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Telephone | 516-967-0677
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Fax | 516-636-0047
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Authorized Official
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Title or Position | CEO
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Name | DR. KEVIN GLASSMAN
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Credential | MD
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Telephone | 516-967-0677
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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 |
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License Number State |
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