Organization
FREDERICKSBURG ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC E. KOCH M.D. (PRESIDENT & CEO)
(914) 637-3511
Entity
Organization
Contact information
Practice address
4103 LAFAYETTE BLVD, FREDERICKSBURG, VA 22408-4274
(540) 371-9696
(540) 371-2046
Mailing address
450 MAMARONECK AVE STE 201, HARRISON, NY 10528-2436
(914) 637-2075
(914) 819-0061
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740435759
—
VA
Enumeration date
11/19/2008
Last updated
04/03/2019
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