Intrepid Lane Anesthesia Group PLLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

Legal business name

INTREPID LANE ANESTHESIA GROUP PLLC

Practice address

190 Intrepid LN
Syracuse, NY 13205-2545

Phone

(315) 498-6200

Fax

(315) 498-6462

NPI assigned

Oct 19, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Campanile, MD

Title

President

Phone

(315) 498-6200

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1093704363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2005",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130574505",
            "telephone_number": "315-449-0513",
            "fax_number": "315-445-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052545",
            "telephone_number": "315-498-6200",
            "fax_number": "315-498-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID LANE ANESTHESIA GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "CAMPANILE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-498-6200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Interim Healthcare of Syracuse, Inc
• Internist Associates of Central New York PC
• Internist Associates of Central New York PC
• Internist Associates of Central New York, PC
• Intouch Counseling LCSW
• Intrepid Lane ASC, LLC
• Edward Ioffe, MD
• Michael B Iorga, MD
• Miron A Iosilevich, MD
• Lauren Ambrose Ippoliti, LCSW-R

• Anesthesiology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Anesthesiology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.