Provider Demographics
NPI:1750497475
Name:GAZAILLE, RAYMOND A (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:A
Last Name:GAZAILLE
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 1:95 LE BRUN AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-3532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 CASS AVE
Practice Address - Street 2:A & B ANESTHESIA ASSOCIATES
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4705
Practice Address - Country:US
Practice Address - Phone:401-769-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223666367500000X
RIRNA36575367500000X
VA0024185613367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA0965Medicare ID - Type UnspecifiedMASSACHUSETTS MEDICARE
RI007057223Medicare ID - Type UnspecifiedRHODE ISLAND MEDICARE