MEDICARE: PALISADES ANESTHESIA ASSOCIATES, PC

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	:	1316690878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PALISADES ANESTHESIA ASSOCIATES, PC

Provider Business Mailing Address
First Line	:	472 N WOODLAND ST
Second Line	:
City	:	ENGLEWOOD
State	:	NJ
Zip	:	07631-2028
Country	:	US
Telephone Number	:	201-674-3802
Fax Number	:

Provider Business Practice Location Address
First Line	:	166 E 88TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-2255
Country	:	US
Telephone Number	:	212-410-3350
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOCELYNE SAJOUS
Credential	:	MD
Telephone Number	:	201-674-3802

Provider Enumeration Date	:	02/03/2022
Last Update Date	:	02/03/2022

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