Provider Demographics
NPI:1932126703
Name:NORTH JERSEY ANESTHESIA ASSOCIATES PA
Entity Type:Organization
Organization Name:NORTH JERSEY ANESTHESIA ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUNG
Authorized Official - Middle Name:DU
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-427-9065
Mailing Address - Street 1:262 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-1201
Mailing Address - Country:US
Mailing Address - Phone:973-427-9065
Mailing Address - Fax:973-427-4995
Practice Address - Street 1:220 HAMBURG TPKE STE 4
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2132
Practice Address - Country:US
Practice Address - Phone:973-942-0400
Practice Address - Fax:973-942-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA028375174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1K9165OtherHEALTHNET
NJA510336OtherOXFORD
NJ527599Medicare ID - Type Unspecified