Provider Demographics
NPI:1346235389
Name:ROUPAS, GIACINTA (CRNA)
Entity Type:Individual
Prefix:
First Name:GIACINTA
Middle Name:
Last Name:ROUPAS
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 1:396 WELSH RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6440
Mailing Address - Country:US
Mailing Address - Phone:267-242-4126
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:DEPT OF ANESTHESIA
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103
Practice Address - Country:US
Practice Address - Phone:856-342-2425
Practice Address - Fax:856-968-8239
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN512303L163W00000X
PA053601367500000X
NJ053601367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1377359OtherHIGHMARK
PA2069051000OtherINDEP. BLUE CROSS
PA82830OtherGEISINGER
PA1377359OtherKHP CENTRAL
PA430070724OtherRAIL ROAD
PA50003129OtherCAPITAL ADVANTAGE
PA1377359OtherHIGHMARK
PA1377359OtherKHP CENTRAL