Provider Demographics
NPI:1760731913
Name:A&E ANESTHESIA ASSOCIATE LLC
Entity Type:Organization
Organization Name:A&E ANESTHESIA ASSOCIATE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:MR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:ELKHOLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-688-6866
Mailing Address - Street 1:2090 ROUTE 27
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1141
Mailing Address - Country:US
Mailing Address - Phone:609-688-6866
Mailing Address - Fax:732-746-0223
Practice Address - Street 1:2090 ROUTE 27
Practice Address - Street 2:SUITE - 103
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1141
Practice Address - Country:US
Practice Address - Phone:609-688-6866
Practice Address - Fax:732-746-0223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty