MEDICARE: UTAH ANESTHESIA SERVICES 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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1245956648
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTAH ANESTHESIA SERVICES LLC

Provider Business Mailing Address
First Line	:	111 TOWN SQUARE PL STE 420
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07310-1724
Country	:	US
Telephone Number	:	888-589-8550
Fax Number	:	201-604-6571

Provider Business Practice Location Address
First Line	:	50 W BROADWAY STE 300
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84101-2044
Country	:	US
Telephone Number	:	888-589-8550
Fax Number	:	201-604-6571

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HAROON CHAUDHRY
Credential	:	MD
Telephone Number	:	917-621-6854

Provider Enumeration Date	:	10/17/2022
Last Update Date	:	10/17/2022

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Directions to “UTAH ANESTHESIA SERVICES LLC ” Practice Location

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