Organization
ADVANCED AMBULATORY ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL A REUVENI M.D. (PRESIDENT)
(862) 229-0559
Entity
Organization
Contact information
Practice address
1176 HAMBURG TPKE, WAYNE, NJ 07470-5054
(862) 229-0559
Mailing address
PO BOX 343, MIDLAND PARK, NJ 07432-0343
(862) 229-0559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8038309
—
NJ
Enumeration date
05/24/2005
Last updated
04/29/2020
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