Healthcare Provider Details

I. General information

NPI: 1083601603
Provider Name (Legal Business Name): EDWARD F. SAYRES CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BERNVILLE RD
READING PA
19605-9453
US

IV. Provider business mailing address

2500 BERNVILLE RD
READING PA
19605-9453
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-2823
  • Fax: 610-378-2272
Mailing address:
  • Phone: 610-378-2823
  • Fax: 610-378-2272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN283763L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number071294
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: