Provider Demographics
NPI:1699984427
Name:PORT JERVIS ANESTHESIOLOGY ASSOCIATES, PLLC
Entity type:Organization
Organization Name:PORT JERVIS ANESTHESIOLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CONTEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-357-7830
Mailing Address - Street 1:133 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5614
Mailing Address - Country:US
Mailing Address - Phone:845-357-7830
Mailing Address - Fax:845-357-8263
Practice Address - Street 1:160 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771-2114
Practice Address - Country:US
Practice Address - Phone:845-357-7830
Practice Address - Fax:845-357-8263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative MedicineGroup - Single Specialty