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General NPI Number Information
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NPI Number | 1689628786
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Entity Type | Organization
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Legal Business Name | ANESTHESIOLOGY ASSOCIATES OF BENNINGTON
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DRIVE ANESTHESIA DEPARTMENT
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City | BENNINGTON
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State | VT
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Zip | 05201-5004
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Country | US
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Telephone | 802-447-5590
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Fax | 802-440-6099
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Provider Business Mailing Address
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Address Line | PO BOX 252
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City | LEWISTON
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State | ME
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Zip | 04243-0252
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Country | US
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Telephone | 800-720-1664
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Fax | 207-753-2020
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Authorized Official
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Title or Position | PRESIDENT
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Name | E. MICHAEL TARAZI
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Credential | MD
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Telephone | 802-447-5590
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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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Taxonomy #2
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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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