Healthcare Provider Details

I. General information

NPI: 1841540341
Provider Name (Legal Business Name): TOMS RIVER AMBULATORY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 SHREWSBURY AVE STE 308
SHREWSBURY NJ
07702-4151
US

IV. Provider business mailing address

655 SHREWSBURY AVE STE 308
SHREWSBURY NJ
07702-4151
US

V. Phone/Fax

Practice location:
  • Phone: 732-945-3921
  • Fax:
Mailing address:
  • Phone: 732-945-3921
  • Fax: 888-247-9636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA04931500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THEODORE E KUTZIN
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 732-264-1127