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General NPI Number Information
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NPI Number | 1336437557
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Entity Type | Organization
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Legal Business Name | UNION ANESTHESIA SERVICES PC
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Dates
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Enumeration Date | 07/21/2011
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 726 4TH ST
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City | MARYSVILLE
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State | CA
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Zip | 95901-5656
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Country | US
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Telephone | 914-637-2063
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Fax |
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Provider Business Mailing Address
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Address Line | 10 COMMERCE DR
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5253
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Country | US
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Telephone | 914-637-2063
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Fax | 914-365-6307
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MARC E KOCH
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Credential | M.D.
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Telephone | 914-637-3563
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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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