Provider Demographics
NPI:1538574272
Name:NORTHSTAR ANESTHESIA OF MASSACHUSETTS II, PLLC
Entity type:Organization
Organization Name:NORTHSTAR ANESTHESIA OF MASSACHUSETTS II, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-583-7421
Mailing Address - Street 1:2000 E LAMAR BLVD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-7346
Mailing Address - Country:US
Mailing Address - Phone:817-583-7421
Mailing Address - Fax:817-861-3926
Practice Address - Street 1:2000 E LAMAR BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7346
Practice Address - Country:US
Practice Address - Phone:817-861-3994
Practice Address - Fax:817-861-3926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty