Provider Demographics
NPI:1366753857
Name:FLOTECH OFFICE ANESTHESIA, PLLC
Entity type:Organization
Organization Name:FLOTECH OFFICE ANESTHESIA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:UNGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-867-8709
Mailing Address - Street 1:474 W 238TH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2027
Mailing Address - Country:US
Mailing Address - Phone:347-867-8709
Mailing Address - Fax:866-420-4899
Practice Address - Street 1:474 W 238TH ST APT 3A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2027
Practice Address - Country:US
Practice Address - Phone:347-867-8709
Practice Address - Fax:866-420-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239359207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY028 01 912Medicaid
I 626 42Medicare UPIN
18 1835 T 1Medicare PIN