Provider Demographics
NPI:1740566504
Name:FARELLI, JOSEPH ANDREW (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ANDREW
Last Name:FARELLI
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 1:122 MCCRACKEN DR
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-2768
Mailing Address - Country:US
Mailing Address - Phone:724-774-1156
Mailing Address - Fax:
Practice Address - Street 1:1501 REEDSDALE ST
Practice Address - Street 2:SUITE 4004
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233-2341
Practice Address - Country:US
Practice Address - Phone:412-363-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN566599367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered