Healthcare Provider Details

I. General information

NPI: 1316136922
Provider Name (Legal Business Name): MICHAEL SAVERIANO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 FAWNWOOD DR
VOORHEES NJ
08043-3944
US

IV. Provider business mailing address

255 W MICHIGAN AVE P. O. BOX 1123
JACKSON MI
49201-2218
US

V. Phone/Fax

Practice location:
  • Phone: 609-841-3049
  • Fax:
Mailing address:
  • Phone: 517-787-6440
  • Fax: 517-787-4146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NR11987000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: