Provider Demographics
NPI:1215010590
Name:NORTHERN ANESTHESIA, P.A.
Entity Type:Organization
Organization Name:NORTHERN ANESTHESIA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHREM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-653-9399
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-0128
Mailing Address - Country:US
Mailing Address - Phone:908-653-9399
Mailing Address - Fax:908-653-9305
Practice Address - Street 1:8 PINEWOOD TER
Practice Address - Street 2:
Practice Address - City:KINNELON
Practice Address - State:NJ
Practice Address - Zip Code:07405-2186
Practice Address - Country:US
Practice Address - Phone:908-653-9399
Practice Address - Fax:908-653-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty