Healthcare Provider Details
I. General information
NPI: 1811368871
Provider Name (Legal Business Name): AMBULATORY ANESTHESIA ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/15/2015
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
61 MAIN ST D
WEST ORANGE NJ
07052-5352
US
IV. Provider business mailing address
312 COURTYARD DR
HILLSBOROUGH NJ
08844-4253
US
V. Phone/Fax
- Phone: 908-653-9399
- Fax:
- Phone: 908-653-9399
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BIJAL
PARIKH
Title or Position: OWNER
Credential: MD
Phone: 908-653-9399