Provider Demographics
NPI:1487761474
Name:HAMILTON ANESTHESIA ASSOCIATES, PC
Entity type:Organization
Organization Name:HAMILTON ANESTHESIA ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-581-5303
Mailing Address - Street 1:PO BOX 10439
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08650-4039
Mailing Address - Country:US
Mailing Address - Phone:609-581-0770
Mailing Address - Fax:609-631-6839
Practice Address - Street 1:2119 HIGHWAY 33
Practice Address - Street 2:SUITE B
Practice Address - City:HAMILTON SQUARE
Practice Address - State:NJ
Practice Address - Zip Code:08690-1740
Practice Address - Country:US
Practice Address - Phone:609-581-5303
Practice Address - Fax:609-631-6839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2K2874OtherHEALTHNET
NJCG4401OtherRAILROAD MEDICARE
NJ7933703Medicaid
2K2874OtherHEALTHNET