Healthcare Provider Details

I. General information

NPI: 1942011192
Provider Name (Legal Business Name): SERENE SKY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR
FLEMINGTON NJ
08822-4604
US

IV. Provider business mailing address

15 MAIN ST UNIT 82
FLEMINGTON NJ
08822-7404
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6100
  • Fax:
Mailing address:
  • Phone: 609-412-5045
  • 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: JACOB E EMBEE
Title or Position: OWNER
Credential: DO
Phone: 609-412-5045