Provider Demographics
NPI:1124019492
Name:AMBULATORY ANESTHESIA OF NJ
Entity Type:Organization
Organization Name:AMBULATORY ANESTHESIA OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-989-2644
Mailing Address - Street 1:343 MOUNT HOPE AVE
Mailing Address - Street 2:SUITE 506
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-1644
Mailing Address - Country:US
Mailing Address - Phone:973-989-2644
Mailing Address - Fax:973-989-2645
Practice Address - Street 1:343 MOUNT HOPE AVE
Practice Address - Street 2:SUITE 506
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-1644
Practice Address - Country:US
Practice Address - Phone:973-989-2644
Practice Address - Fax:973-989-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA056413207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Not Answered207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJAM736713Medicare ID - Type Unspecified