Organization
INTREPID LANE ANESTHESIA GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CAMPANILE MD (PRESIDENT)
(315) 498-6200
Entity
Organization
Contact information
Practice address
190 INTREPID LN, SYRACUSE, NY 13205-2545
(315) 498-6200
(315) 498-6462
Mailing address
PO BOX 2005, EAST SYRACUSE, NY 13057-4505
(315) 449-0513
(315) 445-2936
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/19/2005
Last updated
08/09/2007
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