Basic Information
| Provider Information | |||||||||
| NPI: | 1376865154 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HAMILTON GI ANESTHESIA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1374 WHITEHORSE HAMILTON SQUARE RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086903701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095861319 | ||||||||
| FaxNumber: | 6095861468 | ||||||||
| Practice Location | |||||||||
| Address1: | 1374 WHITEHORSE HAMILTON SQUARE RD | ||||||||
| Address2: | 2ND FLOOR | ||||||||
| City: | HAMILTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 086903701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095861319 | ||||||||
| FaxNumber: | 6095861468 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2010 | ||||||||
| LastUpdateDate: | 05/26/2010 | ||||||||
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| AuthorizedOfficialLastName: | AFRIDI | ||||||||
| AuthorizedOfficialFirstName: | SHARIQ | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6095861319 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HAMILTON GASTROENTEROLOGY GROUP, PC | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.