MEDICARE: EASTSIDE ANESTHESIA PLLC

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	247968-1	NY

General Provider Information

NPI Number	:	1588918999
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EASTSIDE ANESTHESIA PLLC

Provider Business Mailing Address
First Line	:	133 E 58TH ST STE 306
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1173
Country	:	US
Telephone Number	:	212-203-8744
Fax Number	:	212-203-8039

Provider Business Practice Location Address
First Line	:	460 PARK AVE RM 803
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-1837
Country	:	US
Telephone Number	:	212-203-8744
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BIRAJ PATEL
Credential	:
Telephone Number	:	212-203-8744

Provider Enumeration Date	:	11/07/2012
Last Update Date	:	02/05/2026

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