MEDICARE: MR. ROBERT SYDNOR SAFRIET 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	041144814	IL

General Provider Information

NPI Number	:	1467444224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT SYDNOR SAFRIET CRNA

Provider Business Mailing Address
First Line	:	211 S 3RD ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62220-1915
Country	:	US
Telephone Number	:	618-234-2120
Fax Number	:	618-641-5810

Provider Business Practice Location Address
First Line	:	211 S 3RD ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62220-1915
Country	:	US
Telephone Number	:	618-234-2120
Fax Number	:	618-641-5810

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/10/2011

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