Provider Demographics
NPI:1053396580
Name:HACKETTSTOWN ANESTHESIA ASSOCIATES
Entity type:Organization
Organization Name:HACKETTSTOWN ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-934-5869
Mailing Address - Street 1:PO BOX 4744
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17604-4744
Mailing Address - Country:US
Mailing Address - Phone:732-582-2660
Mailing Address - Fax:
Practice Address - Street 1:3130 STATE ROUTE 10 STE 200
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-3454
Practice Address - Country:US
Practice Address - Phone:973-328-3475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-07
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty