Provider Demographics
NPI:1154314284
Name:NAWOJ, BRIAN E (CRNA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:E
Last Name:NAWOJ
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 1:87 MCGREGOR ST
Mailing Address - Street 2:STE. 1400
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3731
Mailing Address - Country:US
Mailing Address - Phone:603-647-9325
Mailing Address - Fax:603-647-2453
Practice Address - Street 1:87 MCGREGOR ST
Practice Address - Street 2:STE. 1400
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3731
Practice Address - Country:US
Practice Address - Phone:603-647-9325
Practice Address - Fax:603-647-2453
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH022519-23-11367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH022519-23-11OtherARNP - CRNA LICENSE
NH022519-23-11OtherARNP - CRNA LICENSE