Healthcare Provider Details

I. General information

NPI: 1215916036
Provider Name (Legal Business Name): JUSTIN A CWYNAR CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4485 WILLIAM FLYNN HWY SUITE 3
ALLISON PARK PA
15101-1424
US

IV. Provider business mailing address

4485 WILLIAM FLYNN HWY SUITE 3
ALLISON PARK PA
15101-1424
US

V. Phone/Fax

Practice location:
  • Phone: 412-492-0800
  • Fax: 412-492-4057
Mailing address:
  • Phone: 412-492-0800
  • Fax: 412-492-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN315574L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: