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NPI Code Detail

MEDICARE: JASON DANIEL LAURIENZO DNP, CRNA

MEDICARE: JASON DANIEL LAURIENZO DNP, 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
1367500000XCertified Registered Nurse AnesthetistAPRN.CRNA.0021590OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116786829OTHERCAQH

General Provider Information

NPI Number : 1558192096
Entity Type Code : Individual
Provider Name (Legal Business Name) : JASON DANIEL LAURIENZO DNP, CRNA
Provider Business Mailing Address
First Line : 6603 FOREST AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44129-2731
Country : US
Telephone Number : 216-970-5165
Fax Number :
Provider Business Practice Location Address
First Line : 1044 BELMONT AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1006
Country : US
Telephone Number : 330-746-7211
Fax Number : 330-286-5396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2024
Last Update Date : 06/11/2026

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