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General NPI Number Information
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NPI Number | 1235773623
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Entity Type | Organization
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Legal Business Name | AVANIA ANESTHESIA PC
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Dates
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Enumeration Date | 10/29/2019
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Last Update Date | 01/29/2020
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Provider Practice Location Address
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Address Line | 2026 STILLWATER DR
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City | GIBSONIA
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State | PA
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Zip | 15044-6200
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Country | US
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Telephone | 724-449-2762
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Fax |
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Provider Business Mailing Address
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Address Line | 1408 11TH AVE FL 2
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City | ALTOONA
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State | PA
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Zip | 16601-3304
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Country | US
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Telephone | 814-414-3891
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KAREN SAMUELS
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Credential | CRNA
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Telephone | 912-223-1870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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