Provider Demographics
NPI:1215359476
Name:PROFESSIONAL ANESTHESIA PHYSICIANS
Entity type:Organization
Organization Name:PROFESSIONAL ANESTHESIA PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHANGZHENG
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-255-6391
Mailing Address - Street 1:4 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-2602
Mailing Address - Country:US
Mailing Address - Phone:718-255-6391
Mailing Address - Fax:718-255-6392
Practice Address - Street 1:4 HICKORY LN
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-2602
Practice Address - Country:US
Practice Address - Phone:718-255-6391
Practice Address - Fax:718-255-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-07
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty