Provider Demographics
NPI:1164419032
Name:CASTAGNA, CARMEL L (CRNA)
Entity Type:Individual
Prefix:
First Name:CARMEL
Middle Name:L
Last Name:CASTAGNA
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 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:400 N 17TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5052
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN308024L163W00000X
PA043397367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11766006OtherCAQH
PA1343221OtherHIGHMARK
PA1343221OtherKHP CENTRAL
PA82836OtherGEISINGER
PA1343221OtherFIRST PRIORITY
PA9059272OtherAETNA
PA1022631480002Medicaid
PA1544586OtherGATEWAY
PA03221601OtherCAPITAL ADVANTAGE
PA2035889000OtherINDEP. BLUE CROSS
PA430070458Medicare PIN
PA03221601OtherCAPITAL ADVANTAGE
PA11766006OtherCAQH