Provider Demographics
NPI:1174510705
Name:VARGAS, TONY P (CRNA)
Entity Type:Individual
Prefix:
First Name:TONY
Middle Name:P
Last Name:VARGAS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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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 1:2545 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7300
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN284390L163W00000X
PA048968367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02228502OtherCAPITAL ADVANTAGE
PA0968265OtherFIRST PRIORITY
PA0968265OtherHIGHMARK
PA1545262OtherGATEWAY
PA73771OtherGEISINGER
PA0437996000OtherINDEP. BLUE CROSS
PA11754815OtherCAQH
PA9204474OtherAETNA
PA0016528370002Medicaid
PA0968265OtherKHP CENTRAL
PA0968265OtherFIRST PRIORITY
PA11754815OtherCAQH
PA0016528370002Medicaid