Organization
PARKSIDE MEDICAL ANESTHESIA ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON CONANT (PRACTICE ADMINISTRATOR)
(716) 836-7510
Entity
Organization
Contact information
Practice address
2157 MAIN STREET, BUFFALO, NY 14214
(716) 836-7510
(716) 836-7511
Mailing address
3871 HARLEM ROAD, SUITE 202, BUFFALO, NY 14215
(716) 836-7510
(716) 836-7511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02190696
—
NY
Enumeration date
06/15/2006
Last updated
06/21/2018
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