Provider Demographics
NPI:1982655064
Name:AMBOY ANESTHESIA ASSOCIATES
Entity Type:Organization
Organization Name:AMBOY ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:M
Authorized Official - Last Name:WROBLESKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-826-4177
Mailing Address - Street 1:PO BOX 997
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857
Mailing Address - Country:US
Mailing Address - Phone:732-826-4177
Mailing Address - Fax:732-607-1160
Practice Address - Street 1:530 NEW BRUNSWICK
Practice Address - Street 2:RARITAN BAY MEDICAL CTR
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861
Practice Address - Country:US
Practice Address - Phone:732-442-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA07600400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0064190Medicaid
I14622Medicare UPIN
NJ0064190Medicaid