Provider Demographics
NPI:1437351764
Name:BARANOWSKI, CECILE R (CRNA)
Entity Type:Individual
Prefix:MS
First Name:CECILE
Middle Name:R
Last Name:BARANOWSKI
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 1:23 ROWE DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03044-3010
Mailing Address - Country:US
Mailing Address - Phone:603-895-2849
Mailing Address - Fax:
Practice Address - Street 1:50 PROSPECT ST
Practice Address - Street 2:SUITE 205
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2841
Practice Address - Country:US
Practice Address - Phone:978-975-0700
Practice Address - Fax:978-975-0775
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73439207LP3000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA0118Medicare PIN