MEDICARE: ANESTHESIOLOGY CONSULTANT OF BROOKLYN, P.C.

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	091990	NY

General Provider Information

NPI Number	:	1245640879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANESTHESIOLOGY CONSULTANT OF BROOKLYN, P.C.

Provider Business Mailing Address
First Line	:	983 51ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3317
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	983 51ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3317
Country	:	US
Telephone Number	:	718-435-4944
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	DR. SAMY LASHEEN
Credential	:	MD
Telephone Number	:	718-435-6441

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	01/13/2016

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