Provider Demographics
NPI:1700011434
Name:ASPEN, ANDREW E (CRNA)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:E
Last Name:ASPEN
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 1:1245 S CEDAR CREST BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN554690163W00000X
PA082602367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11971036OtherCAQH
PA50085972OtherCAPITAL ADVANTAGE
PA2108630OtherHIGHMARK
PA2108630OtherFIRST PRIORITY
PA3716505000OtherIBC
PA3716505000OtherIND. BLUE CROSS
PAASPENANDREW 1Medicaid
PA1582376OtherGATEWAY
PA127184OtherGEISINGER
PA9473427OtherAETNA
PA1582376OtherGATEWAY
PA155314QCYMedicare PIN