Healthcare Provider Details

I. General information

NPI: 1063151546
Provider Name (Legal Business Name): BAY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

561 CRANBURY RD
EAST BRUNSWICK NJ
08816-5400
US

IV. Provider business mailing address

PO BOX 629
FRANKLIN LAKES NJ
07417-0629
US

V. Phone/Fax

Practice location:
  • Phone: 201-847-8079
  • Fax:
Mailing address:
  • Phone: 201-847-8079
  • Fax: 201-847-0059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KAREEM ELTAKI
Title or Position: MEMBER
Credential: MD
Phone: 201-847-8079