Provider Demographics
NPI:1730293598
Name:UNION ANESTHESIA ASSOCIATES, PA
Entity Type:Organization
Organization Name:UNION ANESTHESIA ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEISCHHACKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:908-851-8602
Mailing Address - Street 1:P.O. BOX 415750
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5750
Mailing Address - Country:US
Mailing Address - Phone:908-851-8602
Mailing Address - Fax:908-686-8758
Practice Address - Street 1:695 CHESTNUT STREET
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-851-8602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207L00000X, 207LP2900X, 208VP0014X
NJ207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2691108Medicaid
NJ6566920001OtherMEDICARE DME
NJ2691108Medicaid