Healthcare Provider Details
I. General information
NPI: 1053073585
Provider Name (Legal Business Name): ANESU RESTORATIVE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/12/2021
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3840 QUAKERBRIDGE RD STE 105
HAMILTON NJ
08619-1003
US
IV. Provider business mailing address
3941 AMBERTON WAY
DOYLESTOWN PA
18902-1243
US
V. Phone/Fax
- Phone: 609-581-0002
- Fax: 609-581-0050
- Phone: 609-202-6156
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DOUGLAS
DOWNING
DORIO
Title or Position: NURSE PRACTITIONER/OWNER
Credential: APN-C
Phone: 609-202-6156