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General NPI Number Information
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NPI Number | 1568612331
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Entity Type | Individual
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Provider Name | MARK A KANTOLA CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 118 NATURE PARK RD STE 200
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City | GREENSBURG
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State | PA
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Zip | 15601-6960
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Country | US
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Telephone | 412-359-3155
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Fax | 412-359-3483
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Provider Business Mailing Address
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Address Line | 4727 FRIENDSHIP AVE SUITE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1779
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Country | US
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Telephone | 412-235-5877
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Fax | 412-235-5851
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | RN573756
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License Number State | PA
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