1154379519 NPI number — ANESTHESIA CONSULTANT ASSOCIATES

Table of content: GERARDO INIGO ADILLE RPT (NPI 1922240720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154379519 NPI number — ANESTHESIA CONSULTANT ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANESTHESIA CONSULTANT ASSOCIATES
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:
1154379519
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2333 ELMWOOD AVE
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
KENMORE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14217-2646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-874-1098
Provider Business Mailing Address Fax Number:
716-874-9616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2950 ELMWOOD AVE
Provider Second Line Business Practice Location Address:
KENMORE MERCY HOSPITAL
Provider Business Practice Location Address City Name:
KENMORE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14217-1304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-447-6100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
D'ORAZIO
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING BUSINESS PARTNER
Authorized Official Telephone Number:
716-874-1098

Provider Taxonomy Codes

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

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





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