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General NPI Number Information
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NPI Number | 1639401581
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Entity Type | Individual
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Provider Name | JOSEPH ALEC KATRINCHAK CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 02/03/2010
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Provider Practice Location Address
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Address Line | 860 E BROAD ST SUITE I
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City | ELYRIA
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State | OH
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Zip | 44035-6542
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Country | US
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Telephone | 440-323-8458
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Fax |
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Provider Business Mailing Address
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Address Line | 127 CUMBERLAND CT
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City | ELYRIA
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State | OH
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Zip | 44035-7389
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Country | US
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Telephone | 440-365-4522
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Fax |
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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 | RN-244752
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License Number State | OH
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