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Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
261QR0401X | B4[14] | Comprehensive Outpatient Rehabilitation Facility |
| NPI Number | 1780864926 |
| LBN Legal business name | SHADELAND ANESTHESIA |
| Authorized official | EDWARD KOWLOWITZ - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/05/2007 |
| Last updated | 04/11/2025 - More than a year ago |
| Identifiers | n/a |
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SHADELAND ANESTHESIA
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