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General NPI Number Information
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NPI Number | 1205005840
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Entity Type | Organization
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Legal Business Name | RIK ANESTHESIA ASSOCIATES, LLC.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 20 SHERWOOD DR
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City | WATCHUNG
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State | NJ
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Zip | 07069-6136
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Country | US
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Telephone | 908-668-4664
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Fax | 908-668-1411
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Provider Business Mailing Address
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Address Line | 282 SOUTH AVE
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City | FANWOOD
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State | NJ
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Zip | 07023-1372
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Country | US
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Telephone | 732-850-0132
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Fax |
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Authorized Official
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Title or Position | ANESTHESIOLOGIST/ MEMBER
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Name | DR. TEIMOURAZ V VASSILIDZE
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Credential | M.D., PH.D., DS.C
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Telephone | 732-850-0132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 25MA06904200
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License Number State | NJ
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