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General NPI Number Information
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NPI Number | 1851732358
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Entity Type | Organization
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Legal Business Name | PRIME ANESTHESIA CARE P.C.
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 07/25/2013
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Provider Practice Location Address
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Address Line | 1919 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-2745
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Country | US
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Telephone | 347-417-9094
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Fax |
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Provider Business Mailing Address
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Address Line | 193 DOGWOOD RD
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City | ROSLYN
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State | NY
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Zip | 11576-3005
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Country | US
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Telephone | 347-417-9094
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Fax |
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Authorized Official
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Title or Position | ACCOUNT EXECUTIVE
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Name | JESSICA DALEY
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Credential |
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Telephone | 347-417-9094
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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 |
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License Number State |
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