Healthcare Provider Details

I. General information

NPI: 1811407935
Provider Name (Legal Business Name): BRIDGET NORA LOSCO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIDGET NORA WACLAWIK CRNA

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 2ND AVE
LONG BRANCH NJ
07740-6303
US

IV. Provider business mailing address

22 NORTH ST
RUMSON NJ
07760-1610
US

V. Phone/Fax

Practice location:
  • Phone: 732-222-5200
  • Fax:
Mailing address:
  • Phone: 732-492-4794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NR18514900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number644823-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: