Healthcare Provider Details

I. General information

NPI: 1356608822
Provider Name (Legal Business Name): PRINCETON ANESTHESIA SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 04/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CENTRE DR
MONROE NJ
08831-1564
US

IV. Provider business mailing address

PO BOX 3405
BOSTON MA
02241-0001
US

V. Phone/Fax

Practice location:
  • Phone: 609-252-8760
  • 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
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: GILBERT L DROZDOW
Title or Position: PRESIDENT
Credential: MD
Phone: 954-838-2371