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General NPI Number Information
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NPI Number | 1902939770
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Entity Type | Organization
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Legal Business Name | WESTWOOD ANESTHESIA ASSOCIATES, P.A.
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 250 OLD HOOK RD ANES. DEPT. 2ND FLOOR
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City | WESTWOOD
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State | NJ
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Zip | 07675-3123
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Country | US
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Telephone | 201-358-3190
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Fax | 201-358-6622
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Provider Business Mailing Address
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Address Line | PO BOX 27
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City | WESTWOOD
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State | NJ
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Zip | 07675-0027
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Country | US
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Telephone | 201-358-3190
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Fax | 201-358-6622
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. EUGENE GORMAN
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Credential | M.D.
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Telephone | 201-358-3190
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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 | 25MA05089900
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License Number State | NJ
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