Healthcare Provider Details

I. General information

NPI: 1386924546
Provider Name (Legal Business Name): MONARCH ANESTHESIA OF JERSEY CITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 11/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 HARRISTOWN RD STE 200
GLEN ROCK NJ
07452-3323
US

IV. Provider business mailing address

85 HARRISTOWN RD STE 200
GLEN ROCK NJ
07452-3323
US

V. Phone/Fax

Practice location:
  • Phone: 201-834-1100
  • Fax:
Mailing address:
  • Phone: 201-834-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMA08846400
License Number StateNJ

VIII. Authorized Official

Name: DR. JOHN HAJJAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-834-1100