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General NPI Number Information
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NPI Number | 1851523799
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Entity Type | Organization
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Legal Business Name | BROOKLYN ANESTHESIA GROUP, PC
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Dates
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Enumeration Date | 08/11/2009
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 765 NOSTRAND AVE FL 3
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City | BROOKLYN
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State | NY
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Zip | 11216-4203
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Country | US
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Telephone | 718-433-0044
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Fax | 718-255-6555
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Provider Business Mailing Address
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Address Line | 565 CONWAY RD
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City | ELMONT
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State | NY
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Zip | 11003-3519
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Country | US
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Telephone | 718-433-0044
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Fax | 718-255-6555
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | GINA DUVAL
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Credential |
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Telephone | 718-433-0044
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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 | 177953
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License Number State | NY
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