Provider Demographics
NPI:1942668124
Name:NEPTUNE AMBULATORY ANESTHESIA & PAIN
Entity Type:Organization
Organization Name:NEPTUNE AMBULATORY ANESTHESIA & PAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:E
Authorized Official - Last Name:KUTZIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-264-1127
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-0188
Mailing Address - Country:US
Mailing Address - Phone:732-264-1127
Mailing Address - Fax:732-264-0670
Practice Address - Street 1:3613 ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-3101
Practice Address - Country:US
Practice Address - Phone:732-264-1127
Practice Address - Fax:732-264-0670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-03
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty