Organization
PROFESSIONAL ANESTHESIOLOGY SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM RAO (BUSINESS MANAGER)
(973) 779-7361
Entity
Organization
Contact information
Practice address
211 PENNINGTON AVE, PASSAIC, NJ 07055-4617
(973) 470-3598
(973) 470-3548
Mailing address
PO BOX 458, FAIR LAWN, NJ 07410-0458
(973) 779-7361
(973) 779-7385
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7979401
—
NJ
Enumeration date
06/22/2006
Last updated
09/11/2025
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