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General NPI Number Information
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NPI Number | 1962576322
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Entity Type | Organization
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Legal Business Name | MEADOWLANDS PINNACLE ANESTHESIA
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 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 | 201-840-9490
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Fax | 201-840-9510
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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 | 201-840-9490
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Fax | 201-840-9510
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MR. GEORGE GREER
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Credential |
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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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