Basic Information
| Provider Information | |||||||||
| NPI: | 1326304437 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | L & E ANESTHESIA SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 65 LONG HORIZON RD | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | CT | ||||||||
| PostalCode: | 067511825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5736865550 | ||||||||
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| Practice Location | |||||||||
| Address1: | 722 POST RD | ||||||||
| Address2: | |||||||||
| City: | DARIEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068204744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2036569999 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2012 | ||||||||
| LastUpdateDate: | 05/25/2012 | ||||||||
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| AuthorizedOfficialLastName: | FABRIZI | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5736865550 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 000342 | CT | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.