Provider Demographics
NPI:1568601532
Name:ELITE ANESTHESIA, LLC
Entity Type:Organization
Organization Name:ELITE ANESTHESIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WINIKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-635-1003
Mailing Address - Street 1:1050 WALL ST W
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-3621
Mailing Address - Country:US
Mailing Address - Phone:201-635-1003
Mailing Address - Fax:
Practice Address - Street 1:1050 WALL ST W
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-3621
Practice Address - Country:US
Practice Address - Phone:201-635-1003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-13
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty