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General NPI Number Information
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NPI Number | 1174574321
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Entity Type | Organization
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Legal Business Name | VANGUARD ANESTHESIA ASSOCIATES OF NJ PC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 540 EGG HARBOR RD
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City | SEWELL
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State | NJ
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Zip | 08080-2336
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Country | US
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Telephone | 856-661-5137
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Fax |
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Provider Business Mailing Address
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Address Line | 5355 TOWN CENTER RD 405
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City | BOCA RATON
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State | FL
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Zip | 33486-1005
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Country | US
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Telephone | 561-417-3344
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Fax | 561-417-8899
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TAMARA B GIORDANO
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Credential |
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Telephone | 561-417-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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