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General NPI Number Information
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NPI Number | 1205460748
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Entity Type | Organization
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Legal Business Name | NEW AMSTERDAM ANESTHESIA PC
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 500 ARCADE AVE STE 100
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City | ELKHART
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State | IN
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Zip | 46514-2478
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Country | US
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Telephone | 574-522-9505
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 746163
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City | ATLANTA
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State | GA
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Zip | 30374-6163
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Country | US
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Telephone | 941-360-1566
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Fax | 941-358-9818
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Authorized Official
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Title or Position | VP
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Name | ALEX GORECKI
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Credential |
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Telephone | 800-494-3948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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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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