Healthcare Provider Details

I. General information

NPI: 1669728341
Provider Name (Legal Business Name): JJW ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

16 ROLINS MILL RD
FLEMINGTON NJ
08822-4540
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6180
  • Fax:
Mailing address:
  • Phone: 908-751-5765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN J WILSON
Title or Position: PRESIDENT
Credential: MD
Phone: 908-751-5765