Organization
MONITORED ANESTHESIA CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRAFULLA R SHAH MD (REGISTERED AGENT)
(201) 953-3333
Entity
Organization
Contact information
Practice address
55 S HYDE AVE, UNIT #347, ISELIN, NJ 08830-2180
(201) 953-3333
Mailing address
PO BOX 550, EATONTOWN, NJ 07724-0550
(201) 953-3333
(732) 440-4314
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA03688900
NJ
Other
Enumeration date
07/22/2011
Last updated
07/22/2011
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