Healthcare Provider Details

I. General information

NPI: 1083740591
Provider Name (Legal Business Name): ESSEX ANESTHESIOLISTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 N 13TH ST
NEWARK NJ
07107-1317
US

IV. Provider business mailing address

PO BOX 1406
BLOOMFIELD NJ
07003-1406
US

V. Phone/Fax

Practice location:
  • Phone: 973-268-1400
  • Fax: 973-268-5838
Mailing address:
  • Phone: 973-268-1400
  • Fax: 973-268-5838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BONG HO CHOI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 973-268-1400