Provider Demographics
NPI:1871926642
Name:DELAWARE VALLEY ANESTHESIA LLC
Entity type:Organization
Organization Name:DELAWARE VALLEY ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SISIRA
Authorized Official - Middle Name:KUMARA
Authorized Official - Last Name:ANDRAHENNADY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-864-1740
Mailing Address - Street 1:2 WINDTREE LN
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1662
Mailing Address - Country:US
Mailing Address - Phone:610-864-1740
Mailing Address - Fax:
Practice Address - Street 1:2 WINDTREE LN
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1662
Practice Address - Country:US
Practice Address - Phone:610-864-1740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-15
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD071641L207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty