Healthcare Provider Details

I. General information

NPI: 1154622694
Provider Name (Legal Business Name): NEWTON ANESTHESIA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2010
Last Update Date: 10/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 HIGH ST
NEWTON NJ
07860-1004
US

IV. Provider business mailing address

605 BROAD AVE SUITE 106
RIDGEFIELD NJ
07657-1697
US

V. Phone/Fax

Practice location:
  • Phone: 973-383-2121
  • Fax: 973-579-8563
Mailing address:
  • Phone: 201-943-1203
  • Fax: 201-943-8105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN N KOUVARAS
Title or Position: CEO
Credential: D.O.
Phone: 908-407-7518