Provider Demographics
NPI:1174502108
Name:IMPERIO, DENISE (CRNA)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:IMPERIO
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 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-330-4883
Mailing Address - Fax:412-330-5522
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-330-4883
Practice Address - Fax:412-330-5522
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN279457L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0069802000Medicaid
OH2102656Medicaid
PA020186M50Medicare PIN
PA020186TD6Medicare PIN
PA020186NHDMedicare PIN