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NPI 1235658758

NPI 1235658758 : WEST HUDSON ANESTHESIA PA : SECAUCUS, NJ

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General NPI Number Information
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    NPI Number           |    1235658758
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    Entity Type          |    Organization 
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    Legal Business Name  |    WEST HUDSON ANESTHESIA PA 
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Dates
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    Enumeration Date     |    09/15/2017
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    Last Update Date     |    12/18/2017
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Provider Practice Location Address
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    Address Line         |    55 MEADOWLANDS PKWY 
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    City                 |    SECAUCUS
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    State                |    NJ
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    Zip                  |    07094-2977
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    Country              |    US
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    Telephone            |    201-392-3228
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    Fax                  |    201-392-3526
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Provider Business Mailing Address
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    Address Line         |    181 E 73RD ST 20A
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10021-3549
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    Country              |    US
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    Telephone            |    718-812-4989
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    Fax                  |    718-387-6429
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Authorized Official
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    Title or Position    |    AUTHORIZED OFFICIAL
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    Name                 |     LEONID  ROSIN 
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    Credential           |    MD
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    Telephone            |    718-222-5999
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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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