Provider Demographics
NPI:1063617637
Name:DOMINICK CANNAVO ANESTHESIOLOGY CONSULTING PC
Entity type:Organization
Organization Name:DOMINICK CANNAVO ANESTHESIOLOGY CONSULTING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CANNAVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-754-1818
Mailing Address - Street 1:16 RICHMOND HLS
Mailing Address - Street 2:
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-2301
Mailing Address - Country:US
Mailing Address - Phone:917-754-1818
Mailing Address - Fax:212-362-1683
Practice Address - Street 1:16 RICHMOND HLS
Practice Address - Street 2:
Practice Address - City:IRVINGTON
Practice Address - State:NY
Practice Address - Zip Code:10533-2301
Practice Address - Country:US
Practice Address - Phone:917-754-1818
Practice Address - Fax:212-362-1683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty