Provider Demographics
NPI:1003854779
Name:NEW JERSEY ANESTHESIA/NBIMC L.L.C
Entity Type:Organization
Organization Name:NEW JERSEY ANESTHESIA/NBIMC L.L.C
Other - Org Name:MILLENIUM ANESTHESIA CONSULTANTS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-926-7000
Mailing Address - Street 1:PO BOX 724
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-0724
Mailing Address - Country:US
Mailing Address - Phone:201-943-0034
Mailing Address - Fax:201-943-8105
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:201-943-0034
Practice Address - Fax:201-943-8105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8346208Medicaid
NJ8346208Medicaid