Healthcare Provider Details

I. General information

NPI: 1396797445
Provider Name (Legal Business Name): SOCIETY HILL ANESTHESIA CONSULTANTS OF NEW JERSEY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 ROUTE 70 E
CHERRY HILL NJ
08034-2409
US

IV. Provider business mailing address

804 SCOTT NIXON MEMORIAL DR
AUGUSTA GA
30907-2464
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-3867
  • Fax:
Mailing address:
  • Phone: 800-394-4445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON CWIK
Title or Position: OWNER OF GROUP
Credential: MD
Phone: 215-829-3867