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General NPI Number Information
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NPI Number | 1801191820
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Entity Type | Organization
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Legal Business Name | GARDEN STATE ANESTHESIA MANAGEMENT, LLC
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Dates
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Enumeration Date | 01/22/2011
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Last Update Date | 01/22/2011
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Provider Practice Location Address
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Address Line | 1692 OAK TREE RD
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City | EDISON
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State | NJ
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Zip | 08820-2853
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Country | US
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Telephone | 732-635-9729
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Fax | 732-906-7801
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Provider Business Mailing Address
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Address Line | 1692 OAK TREE RD
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City | EDISON
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State | NJ
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Zip | 08820-2853
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Country | US
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Telephone | 732-635-9729
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Fax | 732-906-7801
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | KISHORI SHAH
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Credential | M.D.
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Telephone | 732-906-0370
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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