Healthcare Provider Details

I. General information

NPI: 1427702117
Provider Name (Legal Business Name): NEW BRUNSWICK ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 12/30/2024
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

220 DAVIDSON AVE STE 124
SOMERSET NJ
08873-4144
US

V. Phone/Fax

Practice location:
  • Phone: 908-519-8520
  • Fax: 908-519-8521
Mailing address:
  • Phone: 908-519-8520
  • Fax: 908-519-8521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 908-519-8520