Organization
BERGEN REGIONAL ANESTHESIOLOGY GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM RAO (OFFICE MANAGER)
(973) 779-7361
Entity
Organization
Contact information
Practice address
230 E RIDGEWOOD AVE, PARAMUS, NJ 07652-4142
(201) 967-4000
Mailing address
PO BOX 1258, CLIFTON, NJ 07012-0758
(973) 779-7361
(973) 779-7358
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA06850700
NJ
208VP0014X
Interventional Pain Medicine Physician
25MA06850700
NJ
Other
Enumeration date
05/25/2010
Last updated
05/25/2010
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