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General NPI Number Information
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NPI Number | 1689746646
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Entity Type | Organization
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Legal Business Name | FRC ANESTHESIA GROUP, PLLC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1829 E 13TH ST SUITE 1A
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City | BROOKLYN
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State | NY
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Zip | 11229-2807
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Country | US
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Telephone | 718-627-8300
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Fax | 718-627-8302
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Provider Business Mailing Address
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Address Line | 108 BURNHAM AVE
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1935
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Country | US
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Telephone | 917-697-7817
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Fax | 516-625-4974
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. ALEKSANDR ROZENBERG
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Credential | M.D.
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Telephone | 917-697-7817
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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 | 232855
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License Number State | NY
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