MEDICARE: SUSAN ELIZABETH ABRAMS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN140613L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	753047838002	OTHER	PA	TRICARE

General Provider Information

NPI Number	:	1043216989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN ELIZABETH ABRAMS CRNA

Provider Business Mailing Address
First Line	:	3147 COLLEGE HEIGHTS BLVD
Second Line	:	COLLEGE HEIGHTS ENDOSCOPY CENTER
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-4813
Country	:	US
Telephone Number	:	610-841-2432
Fax Number	:	610-841-4433

Provider Business Practice Location Address
First Line	:	3147 COLLEGE HEIGHTS BLVD
Second Line	:	COLLEGE HEIGHTS ENDOSCOPY CENTER
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-4813
Country	:	US
Telephone Number	:	610-841-2432
Fax Number	:	610-841-4433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	10/17/2007

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