Healthcare Provider Details

I. General information

NPI: 1811641707
Provider Name (Legal Business Name): NORWOOD ANESTHESIA. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 CRANBURY RD STE 115
EAST BRUNSWICK NJ
08816-4000
US

IV. Provider business mailing address

44 STATE RT 23 STE 15
RIVERDALE NJ
07457-1603
US

V. Phone/Fax

Practice location:
  • Phone: 732-210-4199
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. KATHY IODICE
Title or Position: ADMINISTRATOR
Credential:
Phone: 973-400-1716