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General NPI Number Information
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NPI Number | 1386705481
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Entity Type | Organization
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Legal Business Name | INNOVATIVE AMBULATORY ANESTHESIA ASSOCIATES, LLC
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3613 ROUTE 33
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City | NEPTUNE
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State | NJ
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Zip | 07753
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Country | US
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Telephone | 732-660-1999
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Fax | 732-660-1998
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Provider Business Mailing Address
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Address Line | 3613 ROUTE 33
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City | NEPTUNE
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State | NJ
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Zip | 07753
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Country | US
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Telephone | 732-660-1999
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Fax | 732-660-1998
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT MUSCIO
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Credential | M.D.
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Telephone | 732-660-1999
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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 | 0600282213
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License Number State | NJ
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