Healthcare Provider Details

I. General information

NPI: 1295810976
Provider Name (Legal Business Name): PRINCETON ANESTHESIA SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 WITHERSPOON ST
PRINCETON NJ
08540-3210
US

IV. Provider business mailing address

PO BOX 3405
BOSTON MA
02241-0001
US

V. Phone/Fax

Practice location:
  • Phone: 609-430-7174
  • Fax: 972-932-1312
Mailing address:
  • Phone: 201-804-2800
  • Fax: 201-804-2800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: GILBERT L. DROZDOW
Title or Position: PRESIDENT
Credential: MD
Phone: 954-838-2371