Basic Information
| Provider Information | |||||||||
| NPI: | 1457663486 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BANESTHESIA CONSULTANTS OF NEW JERSEY,L.L.C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 237 SPRINGMEADOW WAY | ||||||||
| Address2: | |||||||||
| City: | MONROE TWP | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088313751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096558709 | ||||||||
| FaxNumber: | 6096553127 | ||||||||
| Practice Location | |||||||||
| Address1: | 285 DAVIDSON AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088734153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322711400 | ||||||||
| FaxNumber: | 7322713544 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2010 | ||||||||
| LastUpdateDate: | 07/07/2010 | ||||||||
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| AuthorizedOfficialLastName: | CLONINGER | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7322711400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367H00000X | 26NJ00199900 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Anesthesiologist Assistant |
No ID Information.