Provider Demographics
NPI:1356322689
Name:TANCRAITOR, JAMES J (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:TANCRAITOR
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:835 HOSPITAL ROAD
Mailing Address - Street 2:PO BOX 788
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-0788
Mailing Address - Country:US
Mailing Address - Phone:724-357-7009
Mailing Address - Fax:724-357-7414
Practice Address - Street 1:835 HOSPITAL ROAD
Practice Address - Street 2:ANESTHESIOLOGY DEPARTMENT
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-0788
Practice Address - Country:US
Practice Address - Phone:724-357-7218
Practice Address - Fax:724-357-7475
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PARN-196809-L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA014104T44Medicare ID - Type Unspecified