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General NPI Number Information
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NPI Number | 1376558791
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Entity Type | Organization
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Legal Business Name | THE MOUNT VERNON ANESTHESIA BILLING SERVICE
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 12 N 7TH AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2026
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Country | US
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Telephone | 914-667-8136
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Fax | 914-667-8136
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Provider Business Mailing Address
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Address Line | 12 N 7TH AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2026
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Country | US
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Telephone | 914-667-8136
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Fax | 914-667-8136
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Authorized Official
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Title or Position | CHAIRMAN OF THE DEPT. OF ANESTHESIA
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Name | DR. BALASA PRASAD
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Credential | M.D.
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Telephone | 914-667-8136
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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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