Healthcare Provider Details

I. General information

NPI: 1578519047
Provider Name (Legal Business Name): TRENTON ANESTHESIOLOGY ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CAPITAL WAY
PENNINGTON NJ
08534-2521
US

IV. Provider business mailing address

1 CAPITAL WAY 2ND FLOOR ANESTHESIA OFFICES
PENNINGTON NJ
08534-2520
US

V. Phone/Fax

Practice location:
  • Phone: 609-394-4221
  • Fax: 609-394-4681
Mailing address:
  • Phone: 609-396-4700
  • Fax: 609-396-4900

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: DR. JOAQUINN CANTILLO
Title or Position: AUTHORIZED REPRESENTATIVE
Credential: MD
Phone: 609-396-4700