Provider Demographics
NPI:1538293220
Name:STRUBINGER JR, BERNARD A (CRNA)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:A
Last Name:STRUBINGER JR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6310 FOURTH STREET
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-8733
Mailing Address - Country:US
Mailing Address - Phone:570-387-0157
Mailing Address - Fax:
Practice Address - Street 1:6310 4TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-8733
Practice Address - Country:US
Practice Address - Phone:570-387-0157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN180918L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018361910010Medicaid
PA0018361910010Medicaid