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General NPI Number Information
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NPI Number | 1881759637
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Entity Type | Organization
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Legal Business Name | DREAMON ANESTHESIA, PC
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Dates
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Enumeration Date | 12/22/2006
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 22 E 88TH ST
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City | NEW YORK
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State | NY
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Zip | 10128-0509
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Country | US
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Telephone | 917-415-8420
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Fax |
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Provider Business Mailing Address
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Address Line | 1365 YORK AVE SUITE #19F
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City | NEW YORK
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State | NY
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Zip | 10021-4035
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Country | US
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Telephone | 917-415-8420
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LYDIA V GRISHIN
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Credential | MD
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Telephone | 917-415-8420
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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 | 223066-1
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License Number State |
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