Organization
ANESTHESIA ASSOCIATES AT ST. MICHAEL'S, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET CHAMPINO (OFFICE MANAGER)
(201) 635-1003
Entity
Organization
Contact information
Practice address
268 MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-2011
(973) 877-5034
Mailing address
PO BOX 1593, SECAUCUS, NJ 07096-1593
(201) 635-1003
(201) 635-1332
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8804702
—
NJ
Enumeration date
09/13/2005
Last updated
01/26/2009
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