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General NPI Number Information
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NPI Number | 1912961723
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Entity Type | Individual
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Provider Name | DAVID JAMES VARGO SR. CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/17/2006
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 4900 BROAD RD
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City | SYRACUSE
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State | NY
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Zip | 13215-2265
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Country | US
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Telephone | 609-581-5303
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Fax | 609-631-6839
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Provider Business Mailing Address
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Address Line | PO BOX 2000
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-4500
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Country | US
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Telephone | 315-446-0033
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Fax | 315-362-5284
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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 | RN352802L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26N010983200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 649073
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License Number State | NY
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