MEDICARE: GREGORY ANESTHESIA SERVICES 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	367H00000X	Anesthesiologist Assistant		NJ
2	174400000X	Specialist		NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1336146893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY ANESTHESIA SERVICES LLC

Provider Business Mailing Address
First Line	:	550 NEWARK AVE
Second Line	:	FL 5TH
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-1326
Country	:	US
Telephone Number	:	201-795-0205
Fax Number	:	201-795-0737

Provider Business Practice Location Address
First Line	:	550 NEWARK AVE
Second Line	:	FL 5TH
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-1326
Country	:	US
Telephone Number	:	201-795-0205
Fax Number	:	201-795-0737

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. AMAURY ROMERO
Credential	:
Telephone Number	:	201-795-0205

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/11/2025

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