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General NPI Number Information
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NPI Number | 1750651303
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Entity Type | Organization
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Legal Business Name | ANESTHESIA AND PAIN MANAGEMENT OF SUFFOLK PC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 205 E MAIN ST STE 1-7
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City | HUNTINGTON
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State | NY
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Zip | 11743-7929
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Country | US
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Telephone | 631-747-0339
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E MAIN ST STE 1-7
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City | HUNTINGTON
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State | NY
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Zip | 11743-7929
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | MISS VERONICA HATZICHRISTOS
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Credential |
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Telephone | 631-747-0339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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