Healthcare Provider Details

I. General information

NPI: 1962640136
Provider Name (Legal Business Name): JASON GIORDANO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 01/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3737 MARKET ST FL 5
PHILADELPHIA PA
19104-5545
US

IV. Provider business mailing address

3737 MARKET ST FL 5
PHILADELPHIA PA
19104-5545
US

V. Phone/Fax

Practice location:
  • Phone: 215-349-8310
  • Fax:
Mailing address:
  • Phone: 215-349-8310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL10034592
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL60A00565
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberL60A00565
License Number StateDE
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN553098
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: