Basic Information
| Provider Information | |||||||||
| NPI: | 1245233048 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREFERRED ANESTHESIA ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 48245 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 071014800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2018042800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3205 FIRE RD | ||||||||
| Address2: | |||||||||
| City: | EGG HARBOR TOWNSHIP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082345884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094071113 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2005 | ||||||||
| LastUpdateDate: | 01/07/2008 | ||||||||
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| AuthorizedOfficialLastName: | SALKELD | ||||||||
| AuthorizedOfficialFirstName: | CHARLES | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF ANESTHESIA | ||||||||
| AuthorizedOfficialTelephone: | 6094071113 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.