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General NPI Number Information
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NPI Number | 1316525801
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Entity Type | Organization
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Legal Business Name | TRISTATE ANESTHESIA PHYSICIANS
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 330 SALEM WOODSTOWN RD STE 8
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City | SALEM
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State | NJ
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Zip | 08079-2034
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Country | US
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Telephone | 201-847-8079
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Fax | 201-847-0059
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Provider Business Mailing Address
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Address Line | PO BOX 629
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City | FRANKLIN LAKES
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State | NJ
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Zip | 07417-0629
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Country | US
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Telephone | 201-847-8079
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Fax | 201-847-0059
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Authorized Official
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Title or Position | MEMBER
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Name | CHANGZHENG WANG
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Credential | MD
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Telephone | 908-922-6797
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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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