Provider Demographics
NPI:1710593694
Name:INTEL ANESTHESIA LLC
Entity Type:Organization
Organization Name:INTEL ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:KANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-595-6775
Mailing Address - Street 1:119 EMERALD VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3446
Mailing Address - Country:US
Mailing Address - Phone:732-595-6775
Mailing Address - Fax:
Practice Address - Street 1:1167 MCBRIDE AVE FL 2
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-2543
Practice Address - Country:US
Practice Address - Phone:973-779-7361
Practice Address - Fax:973-779-7385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty