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General NPI Number Information
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NPI Number | 1871696716
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Entity Type | Organization
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Legal Business Name | PRIVATE ANESTHESIA CONSULTANT PC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 2647 CONEY ISLAND AVE FL 1 PRIVATE ANESTHESIA CONSULTANT PC
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City | BROOKLYN
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State | NY
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Zip | 11223-5502
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Country | US
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Telephone | 718-382-0500
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Fax | 718-382-7025
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Provider Business Mailing Address
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Address Line | 14 WHITEWOOD ROAD PRIVATE ANESTHESIA CONSULTANT, PC
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City | TENAFLY
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State | NJ
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Zip | 07670
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Country | US
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Telephone | 201-567-8814
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACOB PISKUN
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Credential | M.D.
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Telephone | 201-567-8814
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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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