Provider Demographics
NPI:1386654036
Name:AMERICAN ANESTHESIOLOGY OF NEW JERSEY, P.C.
Entity type:Organization
Organization Name:AMERICAN ANESTHESIOLOGY OF NEW JERSEY, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-945-3177
Mailing Address - Street 1:PO BOX 933130
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193-0037
Mailing Address - Country:US
Mailing Address - Phone:973-660-9334
Mailing Address - Fax:973-660-9779
Practice Address - Street 1:30B VREELAND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1926
Practice Address - Country:US
Practice Address - Phone:973-660-9334
Practice Address - Fax:973-660-9779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7370008Medicaid
NJ613712Medicare PIN