Provider Demographics
NPI:1023236403
Name:NORTHERN NEW JERSEY ANESTHESIA ASSOCIATES, LLC
Entity type:Organization
Organization Name:NORTHERN NEW JERSEY ANESTHESIA ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:DETRESPALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-653-9399
Mailing Address - Street 1:25 COMMERCE DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3605
Mailing Address - Country:US
Mailing Address - Phone:908-653-9399
Mailing Address - Fax:908-653-9305
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:908-653-9399
Practice Address - Fax:908-653-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty