Provider Demographics
NPI:1982927349
Name:COURT HOUSE ANESTHESIA LLC
Entity Type:Organization
Organization Name:COURT HOUSE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:THALASSINOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-653-9399
Mailing Address - Street 1:36 DORY DR
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2057
Mailing Address - Country:US
Mailing Address - Phone:908-653-9399
Mailing Address - Fax:
Practice Address - Street 1:36 DORY DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2057
Practice Address - Country:US
Practice Address - Phone:908-653-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty