Provider Demographics
NPI:1285822684
Name:MONZO, DAVID M (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:MONZO
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 1:1225 LINDENHURST RD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5406
Mailing Address - Country:US
Mailing Address - Phone:215-860-3022
Mailing Address - Fax:
Practice Address - Street 1:1225 LINDENHURST RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5406
Practice Address - Country:US
Practice Address - Phone:215-860-3022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN310439L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0185056000OtherINDEPENDENCE BLUE CROSS
PA5494392OtherCIGNA
PA0185056000OtherINDEPENDENCE BLUE CROSS