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NPI Code Detail

MEDICARE: ADVANCED ANESTHESIA ASSOCIATES, PC

MEDICARE: ADVANCED ANESTHESIA ASSOCIATES, PC
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
1174400000XSpecialist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275536070
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED ANESTHESIA ASSOCIATES, PC
Provider Business Mailing Address
First Line : PO BOX 48076
Second Line :
City : NEWARK
State : NJ
Zip : 07101-4876
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 1 E NEW YORK AVE
Second Line :
City : SOMERS POINT
State : NJ
Zip : 08244-2340
Country : US
Telephone Number : 609-653-4300
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : PEYTON DEARBORN
Credential : M.D.
Telephone Number : 609-653-3500
Provider Enumeration Date : 05/24/2005
Last Update Date : 08/22/2020

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