=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760468698
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PARK SLOPE ANESTHESIA ASSOCIATES PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2005
-----------------------------------------------------
Last Update Date | 04/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 506 6TH ST NY METHODIST HOSPITAL
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11215-3609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-780-3000
-----------------------------------------------------
Fax | 646-967-4109
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 517 ROUTE 1 S STE 3050
-----------------------------------------------------
City | ISELIN
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08830-3056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-359-7219
-----------------------------------------------------
Fax | 646-967-4109
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHAIRMAN
-----------------------------------------------------
Name | JOSEPH SCHIANODICOLA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 718-780-3000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------