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General NPI Number Information
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NPI Number | 1528156494
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Entity Type | Organization
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Legal Business Name | MEADOWLANDS ANESTHESIA ASSOCIATES
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 09/17/2008
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Provider Practice Location Address
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Address Line | 581 BERGEN BLVD
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City | RIDGEFIELD
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State | NJ
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Zip | 07657-2030
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Country | US
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Telephone | 201-840-9688
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Fax | 201-840-9663
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Provider Business Mailing Address
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Address Line | PO BOX 36
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City | RIDGEFIELD
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State | NJ
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Zip | 07657-0036
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Country | US
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Telephone | 201-840-9688
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Fax | 201-840-9663
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELE JULIE LEWIS
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Credential | M.D.
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Telephone | 201-840-9688
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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 | MA057851
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License Number State | NJ
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