MEDICARE: EXCEL ANESTHESIA

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	:	1871103705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCEL ANESTHESIA

Provider Business Mailing Address
First Line	:	123 COLUMBIA TPKE STE 102B
Second Line	:
City	:	FLORHAM PARK
State	:	NJ
Zip	:	07932-2193
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 COLUMBIA TPKE STE 102B
Second Line	:
City	:	FLORHAM PARK
State	:	NJ
Zip	:	07932-2193
Country	:	US
Telephone Number	:	973-665-2011
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	PRASHANT PATEL
Credential	:	MD
Telephone Number	:	201-450-3090

Provider Enumeration Date	:	08/05/2020
Last Update Date	:	08/05/2020

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Directions to “EXCEL ANESTHESIA ” Practice Location

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