Healthcare Provider Details

I. General information

NPI: 1124019492
Provider Name (Legal Business Name): AMBULATORY ANESTHESIA OF NJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 MOUNT HOPE AVE SUITE 506
ROCKAWAY NJ
07866-1644
US

IV. Provider business mailing address

343 MOUNT HOPE AVE SUITE 506
ROCKAWAY NJ
07866-1644
US

V. Phone/Fax

Practice location:
  • Phone: 973-989-2644
  • Fax: 973-989-2645
Mailing address:
  • Phone: 973-989-2644
  • Fax: 973-989-2645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMA056413
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMA056413
License Number StateNJ

VIII. Authorized Official

Name: DR. KENNETH ZAHL
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 973-989-2644