Basic Information
| Provider Information | |||||||||
| NPI: | 1235539966 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED ANESTHESIA ASSOCIATES OF NEW JERSEY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1608 LEMOINE AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | FORT LEE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070245622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014616666 | ||||||||
| FaxNumber: | 2014617429 | ||||||||
| Practice Location | |||||||||
| Address1: | 1608 LEMOINE AVE | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | FORT LEE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070245622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014616666 | ||||||||
| FaxNumber: | 2014617429 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2014 | ||||||||
| LastUpdateDate: | 08/29/2014 | ||||||||
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| AuthorizedOfficialLastName: | PATEL | ||||||||
| AuthorizedOfficialFirstName: | AMRISH | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 9175206376 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 25MA05812300 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | 207LP2900X | 25MA07127500 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207LP2900X | 25MA05812300 | NJ | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 207L00000X | 25MA07127500 | NJ | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.