Provider Demographics
NPI:1295372472
Name:ADVANCED ANESTHESIA PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:ADVANCED ANESTHESIA PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIESHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-243-0414
Mailing Address - Street 1:111 CATBRIER WAY
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-1901
Mailing Address - Country:US
Mailing Address - Phone:814-243-0414
Mailing Address - Fax:814-479-5906
Practice Address - Street 1:3 CORNERSTONE DR
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1320
Practice Address - Country:US
Practice Address - Phone:814-243-0414
Practice Address - Fax:814-479-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0000000000000Medicaid