MEDICARE: NEW JERSEY AMBULATORY ANESTHESIA ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1003865692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW JERSEY AMBULATORY ANESTHESIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	PO BOX 18815
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07191-8815
Country	:	US
Telephone Number	:	201-943-5991
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 MADISON AVE
Second Line	:	MORRISTOWN SURGICAL CENTER
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6097
Country	:	US
Telephone Number	:	201-943-5991
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KEVIN M BARRY
Credential	:	M.D.
Telephone Number	:	973-631-8119

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	01/24/2008

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