North Country Ec LLC
Organization Active NPI Certified Registered Nurse Anesthetist · Wilton, NY
NPI 1760171680 · NPPES record last updated Sep 2, 2024
Key facts
- NPI
- 1760171680
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- Legal business name
- NORTH COUNTRY EC LLC
- Practice address
- 135 North Rd BLDG 2
Wilton, NY 12831-1308 - Phone
- (518) 450-1304
- NPI assigned
- May 5, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- NORTH COUNTRY EC LLC
Authorized official
- Name
- Timothy Duffey
- Title
- Exceutive Director
- Phone
- (518) 450-1304
Parent organization (reported in NPPES) 1
Corporate family (same tax ID) 1
Practitioners 14
-
Aaron Goertzen, CRNA
-
Dayna Rose Hansen, CRNA
-
Leslie Stepp Lamar, CRNA
-
Kellie Mann, CRNA
-
Danielle Redmond, CRNA
-
Jacob A Yellen, CRNA
-
Rachael Colucciello, CRNA
-
Christopher R Harrison, SRNA
-
Todd Huber, CRNA
-
Sean Peter McGarry, CRNA
-
Zachery Pezze, CRNA
-
Jennifer Wojtusik, CRNA
-
Amjad M Hammad, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230525001661 | NY | Part B Supplier - Clinic/Group Practice | 9436395910 |
Receives reassigned benefits from 13 practitioners Practice locations: Wilton, NY |
National Provider Directory
- Tax ID family
- North Country Ec LLC
- Part of
- North Country Ec LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | |||
| Certified Registered Nurse Anesthetist |
367500000X | Yes |
Addresses
Primary practice location
135 North Rd BLDG 2
Wilton, NY 12831-1308
Mailing address
PO Box 2005
East Syracuse, NY 13057-4505
Phone (315) 449-0513
Other names
- NE NY Anesth Providers
Other providers in Wilton, NY
- Cathy A. Joss
- Kevin Martuscello
- Shana Susanne Mevissen
- Srikanth Mitta
- North Country Ec LLC
- Northeast Spec Corp
- Kyle Aaron Pearson
- Melissa J Pikor
- Jessica Katherine Purvis
- Rooted Physical Therapy, PLLC
All providers in Wilton, NY · Certified Registered Nurse Anesthetist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.