Northeast Anesthesia Group, LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

25MA06277300 Issued in NJ

Legal business name

NORTHEAST ANESTHESIA GROUP, LLC

Practice address

9226 Kennedy Blvd
Unit a
North Bergen, NJ 07047-5312

Phone

(201) 339-6971

NPI assigned

Oct 7, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. George John Bussanich

Title

President

Phone

(201) 313-4650

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1356625404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "07002",
            "telephone_number": "201-313-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9226 KENNEDY BLVD",
            "address_2": "UNIT A",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475312",
            "telephone_number": "201-339-6971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ANESTHESIA GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "BUSSANICH",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-313-4650",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA06277300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Anesthesiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.