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General NPI Number Information
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NPI Number | 1649218686
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Entity Type | Organization
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Legal Business Name | TROY ANESTHESIOLOGISTS, PC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2215 BURDETT AVENUE SAMARITAN HOSPITAL
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City | TROY
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State | NY
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Zip | 12180
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Country | US
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Telephone | 866-868-8419
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Fax | 845-790-2675
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Provider Business Mailing Address
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Address Line | PO BOX 3308
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City | BUFFALO
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State | NY
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Zip | 14240-3308
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Country | US
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Telephone | 866-868-8419
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Fax | 845-790-2675
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALEXANDER ITENBERG
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Credential | MD
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Telephone | 518-271-3258
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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 | NY
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