Healthcare Provider Details

I. General information

NPI: 1598699639
Provider Name (Legal Business Name): DREAMSCAPES ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

466 OLD HOOK RD STE 1
EMERSON NJ
07630-1368
US

IV. Provider business mailing address

233 LAFAYETTE AVE STE LL5
SUFFERN NY
10901-4822
US

V. Phone/Fax

Practice location:
  • Phone: 201-967-8221
  • Fax:
Mailing address:
  • Phone: 917-747-6977
  • 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: ROMAN FULMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 917-747-6977