Provider Demographics
NPI:1760589154
Name:ZAVARELLA, GWENDOLYN M (CRNA)
Entity Type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:M
Last Name:ZAVARELLA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:GWENDOLYN
Other - Middle Name:MARIE
Other - Last Name:WOOLENSACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 73221
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0002
Mailing Address - Country:US
Mailing Address - Phone:412-578-1354
Mailing Address - Fax:412-578-4981
Practice Address - Street 1:4800 FRIENDSHIP AVENUE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-1354
Practice Address - Fax:412-578-4981
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN571047282N00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00390097OtherRAILROAD MEDICARE
PA106212U31Medicare PIN