Healthcare Provider Details

I. General information

NPI: 1982226965
Provider Name (Legal Business Name): CMD ANESTHESIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 N DEAN ST STE 301
ENGLEWOOD NJ
07631-2527
US

IV. Provider business mailing address

177 N DEAN ST STE 301
ENGLEWOOD NJ
07631-2527
US

V. Phone/Fax

Practice location:
  • Phone: 201-510-3777
  • Fax:
Mailing address:
  • Phone: 201-510-3777
  • 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: NICOLE PATLIAS
Title or Position: CEO
Credential:
Phone: 917-488-9797