1043556285 NPI number — ECLIPSE ANESTHESIA ASSOCIATES PLLC

Table of content: (NPI 1043556285)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043556285 NPI number — ECLIPSE ANESTHESIA ASSOCIATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ECLIPSE ANESTHESIA ASSOCIATES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043556285
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95000-5460
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19195-5460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-937-5947
Provider Business Mailing Address Fax Number:
770-237-1492

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 MARCUS AVE
Provider Second Line Business Practice Location Address:
STE N18
Provider Business Practice Location Address City Name:
NEW HYDE PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11042-2061
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-775-7770
Provider Business Practice Location Address Fax Number:
770-237-1492
Provider Enumeration Date:
12/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
MERRIHEW
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
W
Authorized Official Title or Position:
PRESIDENT/MANAGING PARTNER
Authorized Official Telephone Number:
412-937-5947

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com