Provider Demographics
NPI:1457814311
Name:MEDEX ANESTHESIA
Entity Type:Organization
Organization Name:MEDEX ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:OKAI-KO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-944-0585
Mailing Address - Street 1:13 MUNICIPAL PLZ UNIT 1764
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-7244
Mailing Address - Country:US
Mailing Address - Phone:973-944-0585
Mailing Address - Fax:
Practice Address - Street 1:943 RIVER RD APT B
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-3024
Practice Address - Country:US
Practice Address - Phone:973-944-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty