Basic Information
| Provider Information | |||||||||
| NPI: | 1205812260 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANESTHESIA ASSOCIATES OF YORK PA INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 PINE GROVE COMMONS | ||||||||
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| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174035151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177415257 | ||||||||
| FaxNumber: | 7177415336 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 S GEORGE ST | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174033676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178512345 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | MCGANNON | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7177415257 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | 367500000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | PA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0007106220005 | 05 | PA | MEDICAID |