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NPI Code Detail

MEDICARE: GERALD BROSKEY CRNA

MEDICARE: GERALD BROSKEY 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 AnesthetistRN202312LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
151782OTHERPAGEISINGER HEALTH PLAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942279088
Entity Type Code : Individual
Provider Name (Legal Business Name) : GERALD BROSKEY CRNA
Provider Business Mailing Address
First Line : 1201 GRAMPIAN BLVD
Second Line : PO BOX 3127
City : WILLIAMSPORT
State : PA
Zip : 17701-1900
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 700 HIGH ST
Second Line : WILLIAMSPORT HOSPITAL & MEDICAL CENTER
City : WILLIAMSPORT
State : PA
Zip : 17701-3198
Country : US
Telephone Number : 570-321-2385
Fax Number : 570-321-2479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 01/13/2012

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Directions to “ GERALD BROSKEY CRNA” Practice Location

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