Healthcare Provider Details

I. General information

NPI: 1548372584
Provider Name (Legal Business Name): NYITRAY ANESTHESIA AND PAIN MGMT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 WESCOTT DR
FLEMINGTON NJ
08822-4603
US

IV. Provider business mailing address

PO BOX 607
FLEMINGTON NJ
08822-0607
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6410
  • Fax:
Mailing address:
  • Phone: 908-806-0826
  • Fax: 908-806-0827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA07475100
License Number StateNJ

VIII. Authorized Official

Name: MRS. IWONA LALIK
Title or Position: OFFICE MANAGER
Credential:
Phone: 908-806-0826