Healthcare Provider Details

I. General information

NPI: 1417251836
Provider Name (Legal Business Name): CHILDREN'S ANESTHESIOLOGY ASSOCIATES OF NEW JERSEY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 05/15/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 LAUREL OAK ROAD CHOP SPECIALITY CENTER
VOORHEES NJ
08043-3505
US

IV. Provider business mailing address

100 E PENN SQ THE WANAMAKER BUILDING, 9TH FLOOR,
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 856-782-8750
  • Fax: 215-590-2559
Mailing address:
  • Phone: 267-425-9300
  • Fax: 267-425-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CHERISH FLOWERS
Title or Position: ENROLLMENT MANAGER
Credential:
Phone: 267-425-9408