Provider Demographics
NPI:1073997516
Name:ASCE ANESTHESIA PC
Entity Type:Organization
Organization Name:ASCE ANESTHESIA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIERREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-678-0079
Mailing Address - Street 1:25 ROCKWOOD PL STE 105
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4958
Mailing Address - Country:US
Mailing Address - Phone:917-678-0079
Mailing Address - Fax:201-567-2951
Practice Address - Street 1:25 ROCKWOOD PL STE 105
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4958
Practice Address - Country:US
Practice Address - Phone:917-678-0079
Practice Address - Fax:201-567-2951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty