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General NPI Number Information
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NPI Number | 1386351674
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Entity Type | Organization
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Legal Business Name | SKYLINE ANESTHESIA PLLC
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Dates
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Enumeration Date | 11/04/2022
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Last Update Date | 11/04/2022
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Provider Practice Location Address
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Address Line | 84 W BROADWAY STE 200
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City | DERRY
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State | NH
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Zip | 03038-2323
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Country | US
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Telephone | 509-768-2249
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Fax |
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Provider Business Mailing Address
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Address Line | 362 WESTFORD RD
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City | CONCORD
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State | MA
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Zip | 01742-5236
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CORDELIA NASON
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Credential | MD
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Telephone | 857-544-3195
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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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