Provider Demographics
NPI:1841418787
Name:ANIM, JOSEPH B (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:B
Last Name:ANIM
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 HOGAN DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-2472
Mailing Address - Country:US
Mailing Address - Phone:908-444-8123
Mailing Address - Fax:973-971-2357
Practice Address - Street 1:1308 HOGAN DR
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-2472
Practice Address - Country:US
Practice Address - Phone:908-444-8123
Practice Address - Fax:973-971-2357
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09709500367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ007591Medicare ID - Type Unspecified