Provider Demographics
NPI:1588306880
Name:ALLY ANESTHESIA PLLC
Entity type:Organization
Organization Name:ALLY ANESTHESIA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBOTKA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:316-921-2949
Mailing Address - Street 1:223 WALL ST STE 311
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2060
Mailing Address - Country:US
Mailing Address - Phone:917-575-8964
Mailing Address - Fax:
Practice Address - Street 1:50 ROUTE 111
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3738
Practice Address - Country:US
Practice Address - Phone:917-575-8964
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty