Organization
DELAWARE ANESTHESIA ASSOCIATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR BARRACLOUGH CRNA (PRESIDENT)
(573) 686-5550
Entity
Organization
Contact information
Practice address
42084 STATE HIGHWAY 28, MARGARETVILLE, NY 12455-2820
(573) 686-5550
(573) 686-2139
Mailing address
1780 COUNTY HIGHWAY 41, ROXBURY, NY 12474-1408
(573) 686-5550
(573) 686-2139
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NY132615
WELLCARE NY GROUP
NY
Enumeration date
08/18/2006
Last updated
07/21/2022
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