Organization
PENN VALLEY ANESTHESIA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HAWK CRNA (AUTHORIZED OFFICIAL)
(856) 451-3552
Entity
Organization
Contact information
Practice address
93 COOPER RD, SUITE 100, VOORHEES, NJ 08043-4910
(856) 770-1950
Mailing address
1000 WHITE HORSE RD STE 612, VOORHEES, NJ 08043-4412
(856) 451-3552
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117820
—
NJ
Enumeration date
10/02/2007
Last updated
11/19/2020
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