Provider Demographics
NPI:1093119612
Name:ART OF ANESTHESIA, LLC
Entity type:Organization
Organization Name:ART OF ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:IWAMASA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-729-9353
Mailing Address - Street 1:752 W END AVE
Mailing Address - Street 2:21B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6230
Mailing Address - Country:US
Mailing Address - Phone:212-729-9353
Mailing Address - Fax:
Practice Address - Street 1:752 W END AVE
Practice Address - Street 2:21B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6230
Practice Address - Country:US
Practice Address - Phone:212-729-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08545800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty