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General NPI Number Information
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NPI Number | 1629170170
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ANESTHESIOLOGISTS OF GREATER NEW YORK PC
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Dates
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Enumeration Date | 09/04/2006
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 15 N BROADWAY AREA J
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2214
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Country | US
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Telephone | 914-337-0434
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Fax | 914-337-2810
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Provider Business Mailing Address
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Address Line | 15 N BROADWAY AREA J
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City | WHITE PLAINS
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State | NY
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Zip | 10601-2214
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Country | US
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Telephone | 914-337-0434
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Fax | 914-337-2810
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN DAVID KESTENBAUM
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Credential | M.D.
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Telephone | 914-337-0434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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