Provider Demographics
NPI:1952448805
Name:PRINCETON ANESTHESIA ASSOCIATES, PA
Entity Type:Organization
Organization Name:PRINCETON ANESTHESIA ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:B
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-952-0290
Mailing Address - Street 1:2201 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 171
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2754
Mailing Address - Country:US
Mailing Address - Phone:972-952-0290
Mailing Address - Fax:972-952-0293
Practice Address - Street 1:2201 N CENTRAL EXPY
Practice Address - Street 2:SUITE 171
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2754
Practice Address - Country:US
Practice Address - Phone:972-238-2877
Practice Address - Fax:972-238-2880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0002KDOtherBLUE CROSS BLUE SHIELD
TX00489VMedicare PIN