MEDICARE: RESOURCE ANESTHESIOLOGY ASSOCIATES OF OH, LLC

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

General Provider Information

NPI Number	:	1235434903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESOURCE ANESTHESIOLOGY ASSOCIATES OF OH, LLC

Provider Business Mailing Address
First Line	:	10 COMMERCE DR
Second Line	:
City	:	NEW ROCHELLE
State	:	NY
Zip	:	10801-5253
Country	:	US
Telephone Number	:	914-637-3510
Fax Number	:

Provider Business Practice Location Address
First Line	:	3654 WERK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4900
Country	:	US
Telephone Number	:	513-451-6001
Fax Number	:	513-451-7310

Authorized Official
Title or Position	:	CEO
Name	:	MARC KOCH
Credential	:	MD
Telephone Number	:	914-637-3510

Provider Enumeration Date	:	01/11/2011
Last Update Date	:	01/11/2011

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