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General NPI Number Information
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NPI Number | 1457910150
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Entity Type | Organization
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Legal Business Name | 2BD ANESTHESIA PC
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 501 N LANSDOWNE AVE
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City | DREXEL HILL
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State | PA
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Zip | 19026-1114
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Country | US
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Telephone | 610-853-7723
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1123
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City | JACKSON
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State | MI
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Zip | 49204-1123
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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 | PRESIDENT
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Name | WILLIAM GOLDSTEIN
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Credential | MD
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Telephone | 856-332-8089
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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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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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