Provider Demographics
NPI:1083601603
Name:SAYRES, EDWARD F (CRNA)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:F
Last Name:SAYRES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 BERNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9453
Mailing Address - Country:US
Mailing Address - Phone:610-378-2823
Mailing Address - Fax:610-378-2272
Practice Address - Street 1:2500 BERNVILLE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9453
Practice Address - Country:US
Practice Address - Phone:610-378-2823
Practice Address - Fax:610-378-2272
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN283763L163W00000X
PA071294367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2256029000OtherINDEP. BLUE CROSS
PA84248OtherGEISINGER
PA50026722OtherCAPITAL ADVANTAGE
PA1576146OtherHIGHMARK
PA2000105OtherKHP CENTRAL
PA075776PH7Medicare PIN
PAQ04496Medicare UPIN
PA075776QCYMedicare PIN
PA50026722OtherCAPITAL ADVANTAGE