Anesthesia 24/7, PC
Organization Active NPI Specialist · Berwick, PA
NPI 1942275698 · NPPES record last updated Sep 9, 2015
Key facts
- NPI
- 1942275698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- MD055799L (PA)
- Legal business name
- ANESTHESIA 24/7, PC
- Practice address
- 1200 Freas Ave
Berwick, PA 18603-1612 - Phone
- (570) 752-6441
- Fax
- (570) 752-6442
- NPI assigned
- Feb 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Moin Uddin Mallhi, M.D.
- Title
- Owner
- Phone
- (570) 752-6441
Practitioners 2
-
Moin U Mallhi, M.D.
-
Mona D Justo, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040302000006 | PA | Part B Supplier - Clinic/Group Practice | 5698662039 |
Receives reassigned benefits from 1 practitioner Practice locations: Sunbury, PA; Berwick, PA; Hazleton, PA; Bloomsburg, PA |
National Provider Directory
Locations
1200 Freas Ave
Berwick, PA 18603
Phone (570) 752-6441
1129 Old Berwick Rd
Bloomsburg, PA 17815
Phone (570) 752-6441
130 N 4th St
Sunbury, PA 17801
Phone (570) 286-0303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | MD055799L | PA | Yes |
Addresses
Primary practice location
1200 Freas Ave
Berwick, PA 18603-1612
Mailing address
1200 Freas Ave
Berwick, PA 18603-1612
Phone (570) 752-6441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1541784 | Other | PA | HIGHMARK BS |
| 0019733140001 | Medicaid | PA | |
| 50020367 | Other | PA | CAPITAL BC |
| 1621I | Other | PA | GEISINGER HEALTH PLAN |
Other names
- Columbia Pain Management
Other providers in Berwick, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2015. 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.