Healthcare Provider Details

I. General information

NPI: 1316877392
Provider Name (Legal Business Name): TOMS RIVER AMBULATORY ANESTHESIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1251 RTE 37 W STE 150
TOMS RIVER NJ
08755-5050
US

IV. Provider business mailing address

1251 RTE 37 W STE 150
TOMS RIVER NJ
08755-5050
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-7077
  • Fax: 732-701-3495
Mailing address:
  • Phone: 732-747-7077
  • Fax: 732-701-3495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: THEODORE ELLIS KUTZIN IV
Title or Position: MD
Credential:
Phone: 732-610-9909