Provider Demographics
NPI:1508304742
Name:TRISTATE ANESTHESIOLOGISTS LLC
Entity Type:Organization
Organization Name:TRISTATE ANESTHESIOLOGISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SEKHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-975-1174
Mailing Address - Street 1:102 GUN CLUB RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06903-1024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 LACEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:WHITING
Practice Address - State:NJ
Practice Address - Zip Code:08759-2966
Practice Address - Country:US
Practice Address - Phone:862-686-1327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-08
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA09282300207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty