Organization
VITAL IV INFUSIONS MONTCLAIR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEJASH SHAH CRNA (OWNER)
(856) 712-3505
Entity
Organization
Contact information
Practice address
49 CLAREMONT AVE, MONTCLAIR, NJ 07042-4854
(856) 712-3505
Mailing address
49 CLAREMONT AVE, MONTCLAIR, NJ 07042-4854
(856) 712-3505
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/31/2025
Last updated
03/13/2025
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