MEDICARE: ALGOLOGY 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

General Provider Information

NPI Number	:	1366631996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALGOLOGY ANESTHESIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	PO BOX 374
Second Line	:
City	:	LITTLE FALLS
State	:	NJ
Zip	:	07424-0374
Country	:	US
Telephone Number	:	201-939-0800
Fax Number	:	201-939-2911

Provider Business Practice Location Address
First Line	:	85 ORIENT WAY
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2070
Country	:	US
Telephone Number	:	201-939-0800
Fax Number	:	201-939-2911

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. CHRISTOPHER A SHEKON
Credential	:
Telephone Number	:	201-939-0800

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	04/20/2008

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