Provider Demographics
NPI:1972734184
Name:ANESTHESIA CARE, PC
Entity type:Organization
Organization Name:ANESTHESIA CARE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAITANYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KADIYALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-406-3069
Mailing Address - Street 1:565 PLANDOME RD STE 286
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1945
Mailing Address - Country:US
Mailing Address - Phone:917-406-3069
Mailing Address - Fax:
Practice Address - Street 1:2627 HYLAN BLVD.
Practice Address - Street 2:C/O DR. ALEX BRUCKSTEIN
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306
Practice Address - Country:US
Practice Address - Phone:917-406-3069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-05
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232151207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty