Healthcare Provider Details

I. General information

NPI: 1639400096
Provider Name (Legal Business Name): JERSEY SHORE AMBULATORY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2010
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 ROUTE 35
MIDDLETOWN NJ
07748-2014
US

IV. Provider business mailing address

1270 ROUTE 35
MIDDLETOWN NJ
07748-2014
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • 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: DEAN CINDRARIO
Title or Position: MBR
Credential: MD
Phone: 908-653-9399