1437333911 NPI number — BRIDGET M GUARINO CRNA

Table of content: BRIDGET M GUARINO CRNA (NPI 1437333911)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437333911 NPI number — BRIDGET M GUARINO CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUARINO
Provider First Name:
BRIDGET
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437333911
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 WATERFORD WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALLINGFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19086-7251
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-284-3225
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
CHESTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013-3955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-874-6448
Provider Business Practice Location Address Fax Number:
610-876-7399
Provider Enumeration Date:
12/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  RN526785L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 079372 . This is a "AANA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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