=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093108839
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JERSEY ANESTHESIA SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/17/2015
-----------------------------------------------------
Last Update Date | 03/17/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1117 US HIGHWAY 46 SUITE 201
-----------------------------------------------------
City | CLIFTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07013-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-777-5444
-----------------------------------------------------
Fax | 973-777-0304
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1117 US HIGHWAY 46 SUITE 201
-----------------------------------------------------
City | CLIFTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07013-2449
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-777-5444
-----------------------------------------------------
Fax | 973-777-0304
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. NEIL SINHA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 973-777-5444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------