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Organization
INTERBOROUGH ANESTHESIA
Active
Organization
INTERBOROUGH ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FENAR THEMISTOCLE M.D. (OWNER)
(917) 450-0424
Entity
Organization
Contact information
Practice address
4626 WHITE PLAINS RD, BRONX, NY 10470-1610
(917) 450-0424
Mailing address
4626 WHITE PLAINS RD, BRONX, NY 10470-1327
(917) 450-0424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
217744
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217744
LICENSE
NY
Enumeration date
09/11/2009
Last updated
11/08/2010
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