Provider Demographics
NPI:1215944954
Name:FOSTORIA ANESTHESIA
Entity type:Organization
Organization Name:FOSTORIA ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:ZARKOWER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:419-882-8140
Mailing Address - Street 1:9 BENT CREEK XING
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-4800
Mailing Address - Country:US
Mailing Address - Phone:419-882-8140
Mailing Address - Fax:419-882-8140
Practice Address - Street 1:9 BENT CREEK XING
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-4800
Practice Address - Country:US
Practice Address - Phone:419-882-8140
Practice Address - Fax:419-882-8140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005288174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHB57807Medicare UPIN