Provider Demographics
NPI:1124016761
Name:CECALA, BARBARA W (CRNA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:W
Last Name:CECALA
Suffix:
Gender:F
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:PO BOX 650782
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0782
Mailing Address - Country:US
Mailing Address - Phone:302-733-0806
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:190 W SPROUL RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2097
Practice Address - Country:US
Practice Address - Phone:610-328-8700
Practice Address - Fax:877-329-2370
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN188524L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
022865OtherAANA ID#
PA0018458980Medicaid
PAP00670043OtherRAILROAD MEDICARE PTAN
PA0018458980Medicaid