Provider Demographics
NPI:1073796629
Name:ATLANTIC ANESTHESIA CONSULTANTS LLC
Entity Type:Organization
Organization Name:ATLANTIC ANESTHESIA CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAIXUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-494-1655
Mailing Address - Street 1:1921 OAK TREE ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820
Mailing Address - Country:US
Mailing Address - Phone:732-494-1655
Mailing Address - Fax:732-494-1255
Practice Address - Street 1:1921 OAK TREE ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-494-1655
Practice Address - Fax:732-494-1255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07189700207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty