Healthcare Provider Details

I. General information

NPI: 1871103705
Provider Name (Legal Business Name): EXCEL ANESTHESIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 COLUMBIA TPKE STE 102B
FLORHAM PARK NJ
07932-2193
US

IV. Provider business mailing address

123 COLUMBIA TPKE STE 102B
FLORHAM PARK NJ
07932-2193
US

V. Phone/Fax

Practice location:
  • Phone: 973-665-2011
  • Fax:
Mailing address:
  • Phone:
  • 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: PRASHANT PATEL
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 201-450-3090