Provider Demographics
NPI:1366450694
Name:DOZZI, ALICE MAE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:MAE
Last Name:DOZZI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:ALICE
Other - Middle Name:MAE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5859 SALTSBURG RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-3311
Mailing Address - Country:US
Mailing Address - Phone:412-793-0802
Mailing Address - Fax:
Practice Address - Street 1:400 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:BRADDOCK
Practice Address - State:PA
Practice Address - Zip Code:15104-1599
Practice Address - Country:US
Practice Address - Phone:412-636-5612
Practice Address - Fax:412-636-5689
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN162687L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN162687LOtherRN LICENSE
021489OtherNATIONAL CRNA #
021489OtherNATIONAL CRNA #