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General NPI Number Information
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NPI Number | 1376692368
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Entity Type | Organization
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Legal Business Name | TRI-STATE ANESTHESIA ASSOCIATES LLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 2710 CENTERVILLE RD SUITE 100
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City | WILMINGTON
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State | DE
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Zip | 19808-1644
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Country | US
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Telephone | 302-999-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1032 FOREST LN
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City | GLEN MILLS
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State | PA
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Zip | 19342-9604
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Country | US
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Telephone | 302-999-0200
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CONSTANCE M LINN
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Credential | MD
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Telephone | 302-999-0200
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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 | C2-0006582
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License Number State | DE
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