MEDICARE: HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1164364857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA

Provider Business Mailing Address
First Line	:	PO BOX 64605
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21264-4605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10750 COLUMBIA PIKE
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-4402
Country	:	US
Telephone Number	:	301-681-6772
Fax Number	:	301-681-4461

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL LATTOS
Credential	:
Telephone Number	:	262-442-7066

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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