Provider Demographics
NPI:1568604783
Name:ADVANCED ANESTHESIA LLC
Entity Type:Organization
Organization Name:ADVANCED ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MUSCIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-747-7077
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-0297
Mailing Address - Country:US
Mailing Address - Phone:732-899-6156
Mailing Address - Fax:732-899-5167
Practice Address - Street 1:475 ROUTE 70 STE 203
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5897
Practice Address - Country:US
Practice Address - Phone:732-886-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0600282213207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty