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Organization

NORTHEAST ANESTHESIA GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GEORGE JOHN BUSSANICH (PRESIDENT)
(201) 313-4650
Entity
Organization

Contact information

Practice address
9226 KENNEDY BLVD, UNIT A, NORTH BERGEN, NJ 07047-5312
(201) 339-6971
Mailing address
PO BOX 79, BAYONNE, NJ 07002
(201) 313-4650

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA06277300
NJ

Other

Enumeration date
10/07/2011
Last updated
10/07/2011
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