Provider Demographics
NPI:1801093521
Name:ADVANCED ANESTHESIA AND PAIN
Entity type:Organization
Organization Name:ADVANCED ANESTHESIA AND PAIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROMISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-697-1158
Mailing Address - Street 1:4 BLYTH CT
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3919
Mailing Address - Country:US
Mailing Address - Phone:856-697-1158
Mailing Address - Fax:856-697-0772
Practice Address - Street 1:1007 MANTUA PIKE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3963
Practice Address - Country:US
Practice Address - Phone:856-697-1158
Practice Address - Fax:856-697-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0650759000OtherAMERIHEALTH
NJP3384279OtherOXFORD
NJ2325745000OtherAMERIHEALTH
NJP00304507OtherRAILROAD MEDICARE
NJ7698669OtherAETNA
NJ4655128OtherAETNA
NJ4655128OtherAETNA