1578989612 NPI number — METROPOLITAN ANESTHESIOLOGY ASSOCIATES, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578989612 NPI number — METROPOLITAN ANESTHESIOLOGY ASSOCIATES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN ANESTHESIOLOGY ASSOCIATES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578989612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1550 RAHWAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTCH PLAINS
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07076-2714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-957-1090
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
433 HACKENSACK AVE
Provider Second Line Business Practice Location Address:
LL01
Provider Business Practice Location Address City Name:
HACKENSACK
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07601-6319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-527-6800
Provider Business Practice Location Address Fax Number:
201-342-9381
Provider Enumeration Date:
03/13/2014

Additional Information

Authorized Official

Authorized Official Last Name:
VILLEGAS
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OPERATING MANAGER
Authorized Official Telephone Number:
908-358-5140

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  25MA08090300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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