Healthcare Provider Details

I. General information

NPI: 1033198304
Provider Name (Legal Business Name): SUMMIT ANESTHESIA ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVENUE
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

PO BOX 8500
PHILADELPHIA PA
19178-6872
US

V. Phone/Fax

Practice location:
  • Phone: 908-598-1500
  • Fax: 908-598-0197
Mailing address:
  • Phone: 800-394-4445
  • Fax: 706-650-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GLEN PARIS
Title or Position: PRESIDENT
Credential: MD
Phone: 908-598-1500