Healthcare Provider Details
I. General information
NPI: 1043693633
Provider Name (Legal Business Name): PRECISION ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2015
Last Update Date: 07/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3822 RIVER RD
POINT PLEASANT BORO NJ
08742-2067
US
IV. Provider business mailing address
PO BOX 297
MANASQUAN NJ
08736-0297
US
V. Phone/Fax
- Phone: 732-899-0868
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LESTER
MOLBEGOTT
Title or Position: OWNER
Credential: MD
Phone: 732-899-0868