Provider Demographics
NPI:1053365171
Name:ANESTHESIOLOGISTS OF GLENS FALLS, P.C.
Entity type:Organization
Organization Name:ANESTHESIOLOGISTS OF GLENS FALLS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:PODOLSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-926-5127
Mailing Address - Street 1:PO BOX 1357
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-1357
Mailing Address - Country:US
Mailing Address - Phone:800-720-1664
Mailing Address - Fax:207-753-2020
Practice Address - Street 1:100 PARK ST
Practice Address - Street 2:ANESTHESIA DEPARTMENT
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-4413
Practice Address - Country:US
Practice Address - Phone:518-926-5127
Practice Address - Fax:518-926-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CN3936OtherRAILROAD MEDICARE
CN3936OtherRAILROAD MEDICARE