Provider Demographics
NPI:1033425970
Name:BETHEL ANESTHESIA AND PAIN MANAGEMENT INC
Entity Type:Organization
Organization Name:BETHEL ANESTHESIA AND PAIN MANAGEMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-261-0720
Mailing Address - Street 1:37 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-2604
Mailing Address - Country:US
Mailing Address - Phone:732-261-0720
Mailing Address - Fax:
Practice Address - Street 1:385 SYLVAN AVE
Practice Address - Street 2:SUITE 23
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-2726
Practice Address - Country:US
Practice Address - Phone:732-261-0720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-30
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08408300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ198469Medicare PIN