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General NPI Number Information
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NPI Number | 1720018989
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Entity Type | Organization
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Legal Business Name | MAC ANESTHESIA, PC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 02/26/2011
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Provider Practice Location Address
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Address Line | 19617 HILLSIDE AVE FF
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City | HOLLIS
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State | NY
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Zip | 11423-2157
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Country | US
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Telephone | 718-749-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 19617 HILLSIDE AVE FF
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City | HOLLIS
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State | NY
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Zip | 11423-2157
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Country | US
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Telephone | 718-749-5600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAJESH PATEL
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Credential | M.D.
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Telephone | 718-749-5600
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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 | 198884
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License Number State | NY
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