Provider Demographics
NPI:1760624175
Name:TJ ANESTHESIA SERVICES
Entity Type:Organization
Organization Name:TJ ANESTHESIA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REN
Authorized Official - Middle Name:YU
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-339-6971
Mailing Address - Street 1:PO BOX 79
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-0079
Mailing Address - Country:US
Mailing Address - Phone:201-339-6971
Mailing Address - Fax:201-339-6972
Practice Address - Street 1:8 THOREAU DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4666
Practice Address - Country:US
Practice Address - Phone:973-517-2000
Practice Address - Fax:201-339-6972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-31
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243234-1207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty