Healthcare Provider Details

I. General information

NPI: 1013988054
Provider Name (Legal Business Name): TRINITAS ANESTHESIA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2006
Last Update Date: 04/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WILLIAMSON ST
ELIZABETH NJ
07202-3625
US

IV. Provider business mailing address

PO BOX 48129
NEWARK NJ
07101-4829
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5204
  • Fax:
Mailing address:
  • Phone:
  • 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: LEON PIRAK
Title or Position: HEAD OF GROUP
Credential: MD
Phone: 908-994-5204