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NPI 1336464692

NPI 1336464692 : CEJ ANESTHESIOLOGIST & PAIN MANAGEMENT CONSULTANT PC : REGO PARK, NY

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General NPI Number Information
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    NPI Number           |    1336464692
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    Entity Type          |    Organization 
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    Legal Business Name  |    CEJ ANESTHESIOLOGIST & PAIN MANAGEMENT CONSULTANT PC 
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Dates
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    Enumeration Date     |    03/30/2010
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    Last Update Date     |    03/30/2010
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Provider Practice Location Address
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    Address Line         |    9712 63RD DR 
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    City                 |    REGO PARK
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    State                |    NY
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    Zip                  |    11374-2243
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    Country              |    US
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    Telephone            |    718-830-3388
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 270 
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    City                 |    MASSAPEQUA PARK
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    State                |    NY
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    Zip                  |    11762-0270
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    Country              |    US
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    Telephone            |    631-264-2035
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    Fax                  |    631-264-1418
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ASHRAF F TOMA 
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    Credential           |    M.D.
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    Telephone            |    516-797-0853
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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       |    221350
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    License Number State |    NY
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