Provider Demographics
NPI:1467496208
Name:ABARY, MARIETTA (CRNA)
Entity Type:Individual
Prefix:
First Name:MARIETTA
Middle Name:
Last Name:ABARY
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 1:1800 BYBERRY RD
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-3518
Mailing Address - Country:US
Mailing Address - Phone:215-947-7992
Mailing Address - Fax:
Practice Address - Street 1:1800 BYBERRY RD
Practice Address - Street 2:SUITE 1101
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-3518
Practice Address - Country:US
Practice Address - Phone:215-947-7992
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN186688L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA887416OtherHIGHMARK BLUE SHIELD
PA887416OtherHIGHMARK BLUE SHIELD