MEDICARE: PETER STASINOS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	159167	VA

General Provider Information

NPI Number	:	1083541023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER STASINOS CRNA

Provider Business Mailing Address
First Line	:	472 EDEN ROC CIR APT 205
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-5497
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 FOGG RD
Second Line	:
City	:	WEYMOUTH
State	:	MA
Zip	:	02190-2432
Country	:	US
Telephone Number	:	781-624-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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