Healthcare Provider Details

I. General information

NPI: 1245233048
Provider Name (Legal Business Name): PREFERRED ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 FIRE RD
EGG HARBOR TOWNSHIP NJ
08234-5884
US

IV. Provider business mailing address

PO BOX 48245
NEWARK NJ
07101-4800
US

V. Phone/Fax

Practice location:
  • Phone: 609-407-1113
  • Fax:
Mailing address:
  • Phone: 201-804-2800
  • 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: CHARLES SALKELD
Title or Position: DIRECTOR OF ANESTHESIA
Credential: D.O.
Phone: 609-407-1113