MEDICARE: QUALITY ANESTHESIA SERVICES

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	:	1962033993
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY ANESTHESIA SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 629
Second Line	:
City	:	FRANKLIN LAKES
State	:	NJ
Zip	:	07417-0629
Country	:	US
Telephone Number	:	201-847-8079
Fax Number	:	201-847-0059

Provider Business Practice Location Address
First Line	:	133 N KINDERKAMACK RD
Second Line	:
City	:	MONTVALE
State	:	NJ
Zip	:	07645-1313
Country	:	US
Telephone Number	:	201-847-8079
Fax Number	:	201-847-0059

Authorized Official
Title or Position	:	MEMBER
Name	:	KAREEM ELTAKI
Credential	:	MD
Telephone Number	:	201-847-8079

Provider Enumeration Date	:	01/29/2020
Last Update Date	:	03/27/2024

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