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General NPI Number Information
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NPI Number | 1235712050
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Entity Type | Organization
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Legal Business Name | AMERICAN AIRWAYS, LLC
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Dates
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Enumeration Date | 04/29/2021
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 758 ROUTE 18 NORTH SUITE 103
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816
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Country | US
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Telephone | 732-955-6648
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Fax |
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Provider Business Mailing Address
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Address Line | 7 PLYMOUTH LN
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3322
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Country | US
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Telephone | 732-236-0519
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MORDECHAI BERMANN
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Credential | MD
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Telephone | 732-236-0519
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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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