MEDICARE: GLOBAL ANESTHESIA ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	25MA07232600	NJ

General Provider Information

NPI Number	:	1235430729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLOBAL ANESTHESIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	PO BOX 441
Second Line	:
City	:	ORADELL
State	:	NJ
Zip	:	07649-0441
Country	:	US
Telephone Number	:	201-342-1205
Fax Number	:	201-342-1259

Provider Business Practice Location Address
First Line	:	798 ROUTE 539
Second Line	:
City	:	LITTLE EGG HARBOR TWP
State	:	NJ
Zip	:	08087-4203
Country	:	US
Telephone Number	:	609-296-1122
Fax Number	:	609-296-1142

Authorized Official
Title or Position	:	MEMBER
Name	:	MARK GANTNER
Credential	:	M.D.
Telephone Number	:	201-342-1205

Provider Enumeration Date	:	11/15/2010
Last Update Date	:	02/22/2011

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