Provider Demographics
NPI:1255387536
Name:ANESTHESIA CONSULTANTS OF NEW JERSEY LLC
Entity type:Organization
Organization Name:ANESTHESIA CONSULTANTS OF NEW JERSEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-271-1400
Mailing Address - Street 1:285 DAVIDSON AVE
Mailing Address - Street 2:ACNJ - SUITE 204
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4153
Mailing Address - Country:US
Mailing Address - Phone:732-271-1400
Mailing Address - Fax:732-271-3543
Practice Address - Street 1:285 DAVIDSON AVE
Practice Address - Street 2:ACNJ - SUITE 204
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4153
Practice Address - Country:US
Practice Address - Phone:732-271-1400
Practice Address - Fax:732-271-3543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8009503Medicaid
NJ024248Medicare ID - Type UnspecifiedGROUP MCR #