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General NPI Number Information
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NPI Number | 1053396580
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Entity Type | Organization
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Legal Business Name | HACKETTSTOWN ANESTHESIA ASSOCIATES
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 3130 STATE ROUTE 10 STE 200
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City | DENVILLE
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State | NJ
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Zip | 07834-3454
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Country | US
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Telephone | 973-328-3475
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4744
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City | LANCASTER
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State | PA
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Zip | 17604-4744
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Country | US
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Telephone | 732-582-2660
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILIP LUTZ
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Credential |
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Telephone | 973-934-5869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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