MEDICARE: ADVANCED ANESTHESIA AND PAIN

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	207LP2900X	Pain Medicine (Anesthesiology) Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00304507	OTHER	NJ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0650759000	OTHER	NJ	AMERIHEALTH
2	P3384279	OTHER	NJ	OXFORD
3	2325745000	OTHER	NJ	AMERIHEALTH
5	7698669	OTHER	NJ	AETNA
6	4655128	OTHER	NJ	AETNA

General Provider Information

NPI Number	:	1801093521
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED ANESTHESIA AND PAIN

Provider Business Mailing Address
First Line	:	4 BLYTH CT
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-3919
Country	:	US
Telephone Number	:	856-697-1158
Fax Number	:	856-697-0772

Provider Business Practice Location Address
First Line	:	1007 MANTUA PIKE
Second Line	:
City	:	WOODBURY
State	:	NJ
Zip	:	08096-3963
Country	:	US
Telephone Number	:	856-697-1158
Fax Number	:	856-697-0772

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT J ROMISHER
Credential	:	DO
Telephone Number	:	856-697-1158

Provider Enumeration Date	:	06/27/2007
Last Update Date	:	01/17/2008

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Directions to “ADVANCED ANESTHESIA AND PAIN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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