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NPI Code Detail

MEDICARE: MR. BRIAN R. TRESTON CRNA

MEDICARE: MR. BRIAN R. TRESTON 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 AnesthetistRN291595LPA

General Provider Information

NPI Number : 1558357111
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BRIAN R. TRESTON CRNA
Provider Business Mailing Address
First Line : 16 E BROOKHAVEN RD
Second Line :
City : WALLINGFORD
State : PA
Zip : 19086-6326
Country : US
Telephone Number : 610-618-0167
Fax Number : 610-891-6928
Provider Business Practice Location Address
First Line : 2655 NORTHWINDS PKWY
Second Line :
City : ALPHARETTA
State : GA
Zip : 30009-2280
Country : US
Telephone Number : 877-742-0399
Fax Number : 678-352-4305
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2005
Last Update Date : 03/14/2012

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